Figure 1 from Association between Immune-Related Adverse Events and Atezolizumab in Previously Treated Patients with Unresectable Advanced or Recurrent Non–Small Cell Lung Cancer

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posted on 2024-11-01, 08:20 authored by Hidetoshi Hayashi, Makoto Nishio, Hiroaki Akamatsu, Yasushi Goto, Satoru Miura, Akihiko Gemma, Ichiro Yoshino, Toshihiro Misumi, Takashi Kijima, Naoto Takase, Masaki Fujita, Sadatomo Tasaka, Atsuto Mouri, Tetsuro Kondo, Kei Takamura, Yosuke Kawashima, Kazuyoshi Imaizumi, Shunichiro Iwasawa, Shintaro Nakagawa, Tetsuya Mitsudomi

Association between the occurrences of irAEs and OS or PFS. A, OS according to the onset of irAE, (B) OS according to the grade of irAE, (C) PFS according to the onset of irAE, and (D) PFS according to the grade of irAE. One event with undetermined grade was excluded from the analysis according to grade. NE, not evaluable; NR, not reached.

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ARTICLE ABSTRACT

Real-world, large-scale studies on the association between immune-related adverse events (irAE) and immune checkpoint inhibitor therapy effectiveness are limited. We evaluated overall survival (OS) and progression-free survival based on the occurrence and grade of irAEs. We used data from Japanese patients with unresectable advanced or recurrent non–small cell lung cancer (NSCLC) who received atezolizumab and were enrolled in J-TAIL, a multicenter, prospective, single-arm observational study. Among the 1,002 patients, 190 (19.0%) developed irAEs. The most common irAEs were skin disorders (3.8%) of any grade and interstitial lung disease (1.5%) of grade ≥3. Patients who developed irAEs within 4 or 6 weeks of treatment initiation had higher baseline C-reactive protein levels than those without irAEs. OS was longer in patients with irAEs [HR, 0.66; 95% confidence interval (CI), 0.54–0.82], particularly in those with low-grade irAEs (HR, 0.45; 95% CI, 0.33–0.62), than in patients without irAEs. The HR (95% CI) for OS in patients with low-grade and high-grade skin or endocrine disorder–related irAEs was 0.42 (0.28–0.64) and 0.37 (0.15–0.88), respectively. The HR (95% CI) for OS in patients with low-grade and high-grade irAEs other than skin or endocrine disorders was 0.44 (0.30–0.65) and 1.27 (0.96–1.69), respectively. In patients with unresectable advanced or recurrent NSCLC treated with atezolizumab in real-world settings, irAEs are associated with a clinical benefit except in those with high-grade irAEs other than skin and endocrine disorders. Immune checkpoint inhibitors are useful for treating NSCLC but can cause life-threatening irAEs. This study had a large sample size and stratified the analysis by irAE type and grade. The results suggest that improved management of irAEs may improve the therapeutic effect of atezolizumab.