Article ; Online: A Multicentric, Retrospective, Real-world Study on Immune-related Adverse Events in Patients with Advanced Non-small Cell Lung Cancers Treated with Pembrolizumab Monotherapy.
Clinical oncology (Royal College of Radiologists (Great Britain))
2024 Volume 36, Issue 3, Page(s) 193–199
Abstract: Aims: We present 7 years of clinical experience with single-agent pembrolizumab immune checkpoint inhibitor immunotherapy in non-small cell lung cancers (NSCLC) from four UK cancer centres.: Materials and methods: This multi-institutional ... ...
| Abstract | Aims: We present 7 years of clinical experience with single-agent pembrolizumab immune checkpoint inhibitor immunotherapy in non-small cell lung cancers (NSCLC) from four UK cancer centres. Materials and methods: This multi-institutional retrospective cohort study included 226 metastatic NSCLC patients. Outcomes were number and severity of immune-related adverse events (irAEs), median progression-free survival (mPFS) and median overall survival (mOS). Results: Within our cohort, 119/226 (53%) patients developed irAEs. Of these, 54/119 (45%) experienced irAEs affecting two or more organ systems. The most common irAEs were diarrhoea and rash. The development of an irAE was associated with better mOS (20.7 versus 8.0 months; P < 0.001) and mPFS (12.0 versus 3.9 months; P < 0.001). The development of grade 3/4 toxicities was associated with worse outcomes compared with the development of grade 1/2 toxicities (mOS 6.1 months versus 25.2 months, P < 0.01; mPFS 5.6 months versus 19.3 months, P = 0.01, respectively). Females had a higher proportion of reported grade 3/4 toxicities (13/44 [29.5%] versus 10/74 [13.5%], P = 0.03). Using a multiple Cox regression model, the presence of irAEs was associated with a better overall survival (hazard ratio = 0.42, 95% confidence interval 0.29-0.61; P < 0.01) and better PFS (hazard ratio 0.38, 95% confidence interval 0.27-0.53; P < 0.001). Conclusion: In this multicentre retrospective cohort study, the development of at least one irAE was associated with significantly longer mPFS and mOS; however, more severe grade 3 and 4 irAEs were associated with worse outcomes. Delayed-onset irAEs, after the 3-month timepoint, were associated with better clinical outcomes. |
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| MeSH term(s) | Female ; Humans ; Carcinoma, Non-Small-Cell Lung/pathology ; Retrospective Studies ; Lung Neoplasms/pathology ; Nivolumab/adverse effects ; Antineoplastic Agents, Immunological/adverse effects ; Antibodies, Monoclonal, Humanized | |||||
| Chemical Substances | pembrolizumab (DPT0O3T46P) ; Nivolumab (31YO63LBSN) ; Antineoplastic Agents, Immunological ; Antibodies, Monoclonal, Humanized | |||||
| Language | English | |||||
| Publishing date | 2024-01-16 | |||||
| Publishing country | England | |||||
| Document type | Multicenter Study ; Journal Article | |||||
| ZDB-ID | 1036844-9 | |||||
| ISSN | 1433-2981 ; 0936-6555 | |||||
| ISSN (online) | 1433-2981 | |||||
| ISSN | 0936-6555 | |||||
| DOI | 10.1016/j.clon.2024.01.009 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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