Περίληψη:
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).
Συγγραφείς:
Fountzilas, E.
Lampaki, S.
Koliou, G.-A.
Koumarianou, A.
Levva, S.
Vagionas, A.
Christopoulou, A.
Laloysis, A.
Psyrri, A.
Binas, I.
Mountzios, G.
Kentepozidis, N.
Kotsakis, A.
Saloustros, E.
Boutis, A.
Nikolaidi, A.
Fountzilas, G.
Georgoulias, V.
Chrysanthidis, M.
Kotteas, E.
Vo, H.
Tsiatas, M.
Res, E.
Linardou, H.
Daoussis, D.
Bompolaki, I.
Andreadou, A.
Papaxoinis, G.
Spyratos, D.
Gogas, H.
Syrigos, K.N.
Bafaloukos, D.
Λέξεις-κλειδιά:
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
