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Impact of concomitant medication on clinical outcomes in patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors: A retrospective study.
Miura, Kaho; Sano, Yoshiyuki; Niho, Seiji; Kawasumi, Kenji; Mochizuki, Nobuo; Yoh, Kiyotaka; Matsumoto, Shingo; Zenke, Yoshitaka; Ikeda, Takaya; Nosaki, Kaname; Kirita, Keisuke; Udagawa, Hibiki; Goto, Koichi; Kawasaki, Toshikatsu; Hanada, Kazuhiko.
Afiliación
  • Miura K; Division of Pharmacy, National Cancer Center Hospital East, Chiba, Japan.
  • Sano Y; Department of Pharmacometrics and Pharmacokinetics, Meiji Pharmaceutical University, Tokyo, Japan.
  • Niho S; Division of Pharmacy, National Cancer Center Hospital East, Chiba, Japan.
  • Kawasumi K; Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
  • Mochizuki N; Division of Pharmacy, National Cancer Center Hospital East, Chiba, Japan.
  • Yoh K; Division of Pharmacy, National Cancer Center Hospital East, Chiba, Japan.
  • Matsumoto S; Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
  • Zenke Y; Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
  • Ikeda T; Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
  • Nosaki K; Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
  • Kirita K; Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
  • Udagawa H; Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
  • Goto K; Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
  • Kawasaki T; Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
  • Hanada K; Division of Pharmacy, National Cancer Center Hospital East, Chiba, Japan.
Thorac Cancer ; 12(13): 1983-1994, 2021 07.
Article en En | MEDLINE | ID: mdl-33990133
ABSTRACT

BACKGROUND:

It has recently been suggested that concomitant medication may affect the clinical outcome of patients treated with immune checkpoint inhibitors (ICIs). However, only a few studies on the impact of concomitant medication on immune-related adverse events (irAEs) have previously been reported. Here, we aimed to determine the impact of concomitant medication on the efficacy and safety of ICIs.

METHODS:

We retrospectively analyzed the data of 300 patients treated with nivolumab or pembrolizumab for advanced non-small cell lung cancer (NSCLC) between January 2016 and July 2018. Multivariate logistic regression analysis was used to assess the effect of concomitant medication on treatment response or irAEs. A multivariate Cox proportional hazards model was used to evaluate concomitant medication-related factors associated with time-to-treatment failure or overall survival (OS).

RESULTS:

A total of 70 patients responded to treatment and 137 experienced irAEs. The response rate and incidence of irAEs in patients treated with ICIs were not significantly associated with concomitant medication. Multivariate analysis showed that the use of opioids was an independent factor (time-to-treatment failure hazard ratio 1.39, p = 0.021, OS hazard ratio 1.54, p = 0.007).

CONCLUSIONS:

The efficacy and safety of nivolumab or pembrolizumab in the treatment of patients with advanced NSCLC were not significantly influenced by concomitant medication. However, opioid usage might be associated with shorter OS in patients treated with these ICIs. Further mechanistic investigations should explore whether these associations are purely prognostic or contribute to ICI resistance.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Anticuerpos Monoclonales Humanizados / Nivolumab / Neoplasias Pulmonares Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Thorac Cancer Año: 2021 Tipo del documento: Article País de afiliación: Japón

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Anticuerpos Monoclonales Humanizados / Nivolumab / Neoplasias Pulmonares Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Thorac Cancer Año: 2021 Tipo del documento: Article País de afiliación: Japón