Immune-related Liver Injury is a Poor Prognostic Factor in Patients with Nonsmall Cell Lung Cancer Treated with Immune Checkpoint Inhibitors

Abstract

It remains unclear whether severe liver immune-related adverse events (liver-irAEs) can affect the prognosis in nonsmall cell lung carcinoma (NSCLC) patients. Of the 365 NSCLC patients treated with immune checkpoint inhibitors (ICIs), 19 suffered from severe liver-irAEs (grade ≥3). The median time-to-onset of liver-irAEs was 53 days postinjection of the first ICI. The progression-free survival and overall survival of the liver-irAEs group (median 69 and 262 days, respectively) were significantly worse than the nonliver-irAEs group (128 and 722 days; P = 0.010 and P = 0.007; respectively). In conclusion, liver-irAEs were associated with poor prognosis in NSCLC patients.

Keywords:

• Nonsmall cell lung cancer
• immune checkpoint inhibitor
• immune-related adverse events
• liver injury
• prognosis

Acknowledgments

The authors wish to acknowledge all those who contributed to the collection of cases. English language support was provided by Wiley Editing Services.

Ethics approval

This study was carried out following the tenets of the Declaration of Helsinki and was approved by the Institutional Review Board of Nagoya University Hospital and Ogaki Municipal Hospital (no. 2018-0438, 15006). Informed consent in the present study was obtained in the form of opt-out on the website of Nagoya University Hospital and Ogaki Municipal Hospital.

Declaration of interest

T. Hase received personal fees from AstraZeneca, Chugai Pharmaceutical Co. Ltd., Ono Pharmaceutical Co. Ltd., and Bristol-Myers Squibb Co., outside the submitted work. N. Hashimoto received a research grant from Boehringer Ingelheim, outside the submitted work.

Data availability statement

The original data can be requested from the corresponding author.