Endocrine immune-related adverse event is a prognostic biomarker independent of lead-time bias.
Lung Cancer
; 192: 107790, 2024 Jun.
Article
en En
| MEDLINE
| ID: mdl-38696920
ABSTRACT
OBJECTIVES:
Immune-related adverse events (irAEs) are known to be associated with clinical efficacy and better prognoses in patients receiving immune checkpoint inhibitors. In particular, endocrine irAE (e-irAE) is related to better prognoses. Since the incidence of irAEs increase as treatment duration becomes longer, we should consider lead-time bias not to overvalue the result. We evaluated the impact of e-irAE on the outcome before and after 6-, 9-, and 12-week landmark analyses. MATERIALS ANDMETHODS:
We evaluated 222 patients with advanced or recurrent non-small cell lung cancer who received anti-PD-1 antibodies such as nivolumab or pembrolizumab from January 2016 to April 2021. Treatment efficacy and outcomes of patients with or without e-irAE (e-irAE group or no e-irAE group) were retrospectively evaluated. In addition, we performed 6-, 9-, and 12-week landmark analyses to exclude the effect of lead-time bias.RESULTS:
Median progression free survival (PFS) was significantly longer in the e-irAE group than in the no e-irAE group (overall 15.3 vs 3.9 months, p < 0.0001; 6-week 15.3 vs 4.9 months, p < 0.0002; 9-week 19.8 vs 6.1 months, p = 0.0012, 12-week 19.8 vs 8.4 months, p = 0.017). Overall survival (OS) was significantly longer in the e-irAE group (overall not reached (NR) vs 15.4 months, p = 0.0003; 6-week NR vs 19.1 months, p = 0.0049, 9-week NR vs 22.2 months, p = 0.006; 12-week NR vs 23.3 months, p = 0.04). We used the multivariate cox proportional hazard model to adjust for confounding factors and found that e-irAE had better impact on both PFS and OS (PFS overall hazard ratio 0.37 [95% confidence interval 0.23-0.56], 6-week 0.41 [0.26-0.63], 9-week 0.43 [0.24-0.63], 12-week 0.52 [0.31-0.84]; OS overall 0.40 [0.22-0.68], 6-week 0.46 [0.25-0.79], 9-week 0.47 [0.24-0.84], 12-week 0.58 [0.29-1.08]).CONCLUSION:
The occurrence of endocrine irAE was associated with better efficacy and prognoses regardless of the lead-time bias.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Carcinoma de Pulmón de Células no Pequeñas
/
Inhibidores de Puntos de Control Inmunológico
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Neoplasias Pulmonares
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Lung Cancer
Asunto de la revista:
NEOPLASIAS
Año:
2024
Tipo del documento:
Article
País de afiliación:
Japón