TY - JOUR
TI - Real-world safety and efficacy data of immunotherapy in patients with cancer and autoimmune disease: the experience of the Hellenic Cooperative Oncology Group
AU - Fountzilas, E.
AU - Lampaki, S.
AU - Koliou, G.-A.
AU - Koumarianou, A.
AU - Levva, S.
AU - Vagionas, A.
AU - Christopoulou, A.
AU - Laloysis, A.
AU - Psyrri, A.
AU - Binas, I.
AU - Mountzios, G.
AU - Kentepozidis, N.
AU - Kotsakis, A.
AU - Saloustros, E.
AU - Boutis, A.
AU - Nikolaidi, A.
AU - Fountzilas, G.
AU - Georgoulias, V.
AU - Chrysanthidis, M.
AU - Kotteas, E.
AU - Vo, H.
AU - Tsiatas, M.
AU - Res, E.
AU - Linardou, H.
AU - Daoussis, D.
AU - Bompolaki, I.
AU - Andreadou, A.
AU - Papaxoinis, G.
AU - Spyratos, D.
AU - Gogas, H.
AU - Syrigos, K.N.
AU - Bafaloukos, D.
JO - Cancer Immunology, Immunotherapy
PY - 2022
VL - 71
TODO - 2
SP - 327-337
PB - Springer Science and Business Media Deutschland GmbH
SN - 0340-7004, 1432-0851
TODO - 10.1007/s00262-021-02985-6
TODO - adult;  aged;  autoimmune disease;  female;  follow up;  human;  immunology;  immunotherapy;  male;  middle aged;  mortality;  neoplasm;  pathology;  prognosis;  retrospective study;  survival rate;  very elderly, Adult;  Aged;  Aged, 80 and over;  Autoimmune Diseases;  Female;  Follow-Up Studies;  Humans;  Immune Checkpoint Inhibitors;  Immunotherapy;  Male;  Middle Aged;  Neoplasms;  Prognosis;  Retrospective Studies;  Survival Rate
TODO - Background: Data on the safety and efficacy of immune checkpoint inhibitors (ICI) in patients with concurrent autoimmune diseases (AID) are limited. Methods: We performed a retrospective multicenter review of medical records of patients with cancer and underlying AID who received ICI. The primary endpoint was progression-free survival (PFS). Results: Among 123 patients with pre-existing AID who received ICI, the majority had been diagnosed with non-small cell lung cancer (NSCLC, 68.3%) and melanoma (14.6%). Most patients had a rheumatologic (43.9%), or an endocrine disorder (21.1%). Overall, 74 (60.2%) patients experienced an immune-related adverse event (irAE) after ICI initiation, AID flare (25.2%), or new irAE (35%). Frequent irAEs included thyroiditis, dermatitis and colitis. ICI was permanently discontinued due to unacceptable (8.1%) or fatal (0.8%) toxicity. In patients with NSCLC, corticosteroid treatment at the initiation of immunotherapy was associated with poor PFS (HR = 2.78, 95% CI 1.40–5.50, p = 0.003). The occurrence of irAE was associated with increased PFS (HR = 0.48, 95% CI 0.25–0.92, p = 0.026). Both parameters maintained their independent prognostic significance. Conclusions: ICI in patients with cancer and pre-existing AID is associated with manageable toxicity that infrequently requires treatment discontinuation. However, since severe AID flare might occur, expected ICI efficacy and toxicity must be balanced. Clinical trial identifier: NCT04805099. © 2021, The Author(s).
ER -