Prognostic factors and effect on survival of immune-related adverse events in patients with non-small-cell lung cancer treated with immune checkpoint blockage

Abstract

Our aim was to describe the incidence and characteristics of immune-related adverse events (irAEs) in patients with non-small-cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICI) and to evaluate their impact on outcome. All cases of NSCLC patients treated with ICIs in the second-line setting between December 2015 and May 2018 were evaluated. Seventy patients were included. Mean age was 65.9 years, and the majority of male (n = 53, 75.7%), with PS of 0-1 (n = 62, 88.6%) treated with nivolumab (n = 51; 72.9%). Thirty-one patients (44.3%) experienced an AE, 5 (7.1%) were grades 3–4. Median OS in patients with AE was 30.1 months (95% CI, 16.7–43.5) compared with 5.1 months (95% CI, 1.2–9.0) in cases without AE (log-rank test: p = 0.010). The adjusted HR for OS was 0.46 (95% CI, 0.25–0.86) for the irAE occurrence and 3.60 (95% CI, 1.56–8.32) for PS 2-3 group. The development of irAEs was associated with improved patient outcome.

Keywords:

• Immunotherapy
• adverse events
• lung neoplasm
• survival
• atezolizumab
• nivolumab
• pembrolizumab

Data sharing statement

No additional data are available.

Additional information

Notes on contributors

David Conde-Estévez

David Conde-Estévez, PharmD, PhD, Pharmacy Department, Hospital del Mar; IMIM. Passeig Marítim 24–29, 08003 Barcelona. Pharmacist responsible for the oncology pharmacy unit of the University Hospital of Mar. He is board certified in oncology pharmacy through the board of pharmacy specialties the gold standard for determining which pharmacists are qualified to contribute at advanced practice levels. His main lines of research are: Cancer, immunotherapy, targeted therapy, infectious diseases, medicine personalized. As a regular contributor to International medical publications and meetings, he has published more than 30 articles in his areas of expertise.

Inés Monge-Escartín

Inés Monge, PharmD, Pharmacy Department, Hospital Clinic in Barcelona. At present she is a pharmacist in the Oncology Pharmacy Unit in Hospital Clinic in Barcelona. His main lines of research are antineoplastic therapy, immunotherapy, pharmacokinetics and personalized medicine. She is now collaborating in several projects in the field of cancer treatment.

Alejandro Ríos-Hoyo

Alejandro Ríos MD, Medical Oncology Department, Parc de Salut Mar. Passeig Marítim de la Barceloneta, 25, 29, 08003 Barcelona, Spain. Medical Oncology resident at Hospital Del Mar. Main lines of research: lung cancer, immunotherapy, targeted therapies.

Xavier Monzonis

Xavier Monzonís, MD, Medical Oncology Department, Parc de Salut Mar. Passeig Marítim de la Barceloneta, 25, 29, 08003 Barcelona, Spain. Medical Oncology resident at Hospital Del Mar. Main lines of research: lung cancer, immunotherapy, targeted therapies.

Daniel Echeverría-Esnal

Daniel Echeverria-Esnal, PharmD. Pharmacy Department, Hospital del Mar, Parc de Salut Mar. Passeig Maritim 25–29, Barcelona, Spain. He is a clinical pharmacist of the Hospital del Mar. He is board certified in Infectious Diseases through the board of pharmacy specialties the gold standard for determining which pharmacists are qualified to contribute at advanced practice levels. His main lines or research are: Infectious Diseases, Antimicrobial Stewardship.

Laura Moliner

Moliner Jimenez, Laura, MD, Oncology Department, University Hospital del Mar. Passeig maritim 25–27, 08003, Barcelona, Spain. She is finishing her medical oncology residency at Hospital del Mar in Barcelona. Member of the translational lung cancer research group.

Xavier Duran-Jordà

Xavier Duran Jordá, PhD, Senior Statistician at IMIM Methodology and Biostatistics Support Unit, Institut Hospital del Mar d'Investigacions Médiques (IMIM), 08003 Barcelona, Spain. As a regular contributor to International medical publications and meetings, he has published over 70 articles in great range of areas of clinical research.

Álvaro Taus

Álvaro Taus, MD, Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. He is a medical oncologist at Hospital del Mar in Barcelona (Spain) focused in lung and gynecological cancer. His main lines of research are: lung cancer, gynecological cancer, liquid biopsy, and targeted therapy. He is also principal investigator of many clinical trials.

Edurne Arriola

Edurne Arriola, MD, PhD, Oncology Department, Hospital del Mar; IMIM. Passeig Marítim 24–29, 08003 Barcelona. She is head of thoracic cancer at de medical oncology department and leads the lung cancer research at the Molecular Therapeutics in Cancer laboratory at IMIM. She is also principal investigator of many clinical trials. Her main lines of research are small cell lung cancer and immunotherapy. As a regular contributor to International medical publications and meetings, he has published over 50 articles in her areas of expertise.