journal contribution
posted on 2025-04-03, 21:49 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 <p>Supplementary Table S6. Association between skin or endocrine disorder irAEs and predictors of ICI effect a Mann–Whitney U Test. b Patients who had progression within 4 or 6 weeks after the initiation of treatment were excluded. Abbreviations: CRP, C-reactive protein; ICI, immune checkpoint inhibitor; IHC, immunohistochemical; irAE, immune-related adverse event; NLR, neutrophil-to-lymphocyte ratio; PD-L1, programmed death ligand-1; Q, quartile; SD, standard deviation.</p>
History
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.
