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Real-world safety and efficacy data of immunotherapy in patients with cancer and autoimmune disease: the experience of the Hellenic Cooperative Oncology Group

Authors :
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.
Publication Year :
2022

Abstract

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).

Details

Language :
English
Database :
OpenAIRE
Accession number :
edsair.od......2127..60b68396854ba135951a4a2886c6c74c