Background: Immune-related adverse events (irAEs) are inflammatory side effects, which can occur during immune-checkpoint(s) inhibitors (ICIs) therapy. Steroids are the first-line agents to manage irAEs because of their immunosuppressive properties. However, it is still debated whether or when steroids can be administered without abrogating the therapeutic efforts of immunotherapy. Methods: We retrospectively evaluated 146 patients with metastatic non-small cell lung cancer (NSCLC), melanoma and renal cell carcinoma (RCC) treated with ICIs. We assessed the progression-free survival (PFS) of patients treated with steroids due to an irAE compared to a no-steroid group. Results: The early treatment with steroid (within the first 30 days from the beginning of immunotherapy) was not related to a shorter PFS (p = 0.077). Interestingly, patients who were treated with steroids after 30 days from the start of immunotherapy had significantly longer PFS (p = 0.017). In a multivariate analysis, treatment with steroids after 30 days was an independent prognostic factor for PFS (HR: 0.59 [95% CI 0.36–0.97], p = 0.037). Conclusions: This retrospective study points out that early systemic steroids administration to manage irAEs might not have a detrimental effect on patient clinical outcome in NSCLC, melanoma and RCC patients.

Association of systemic steroid treatment and outcome in patients treated with immune checkpoint inhibitors: A real-world analysis / Paderi A.; Gambale E.; Botteri C.; Giorgione R.; Lavacchi D.; Brugia M.; Mazzoni F.; Giommoni E.; Bormioli S.; Amedei A.; Pillozzi S.; Cerinic M.M.; Antonuzzo L.. - In: MOLECULES. - ISSN 1420-3049. - ELETTRONICO. - 26:(2021), pp. 5789-5815. [10.3390/molecules26195789]

Association of systemic steroid treatment and outcome in patients treated with immune checkpoint inhibitors: A real-world analysis

Paderi A.;Gambale E.;Botteri C.;Giorgione R.;Lavacchi D.;Brugia M.;Giommoni E.;Bormioli S.;Amedei A.;Pillozzi S.;Antonuzzo L.
2021

Abstract

Background: Immune-related adverse events (irAEs) are inflammatory side effects, which can occur during immune-checkpoint(s) inhibitors (ICIs) therapy. Steroids are the first-line agents to manage irAEs because of their immunosuppressive properties. However, it is still debated whether or when steroids can be administered without abrogating the therapeutic efforts of immunotherapy. Methods: We retrospectively evaluated 146 patients with metastatic non-small cell lung cancer (NSCLC), melanoma and renal cell carcinoma (RCC) treated with ICIs. We assessed the progression-free survival (PFS) of patients treated with steroids due to an irAE compared to a no-steroid group. Results: The early treatment with steroid (within the first 30 days from the beginning of immunotherapy) was not related to a shorter PFS (p = 0.077). Interestingly, patients who were treated with steroids after 30 days from the start of immunotherapy had significantly longer PFS (p = 0.017). In a multivariate analysis, treatment with steroids after 30 days was an independent prognostic factor for PFS (HR: 0.59 [95% CI 0.36–0.97], p = 0.037). Conclusions: This retrospective study points out that early systemic steroids administration to manage irAEs might not have a detrimental effect on patient clinical outcome in NSCLC, melanoma and RCC patients.
2021
26
5789
5815
Paderi A.; Gambale E.; Botteri C.; Giorgione R.; Lavacchi D.; Brugia M.; Mazzoni F.; Giommoni E.; Bormioli S.; Amedei A.; Pillozzi S.; Cerinic M.M.; A...espandi
File in questo prodotto:
File Dimensione Formato  
molecules-26-05789-v2.pdf

accesso aperto

Tipologia: Pdf editoriale (Version of record)
Licenza: Creative commons
Dimensione 2.31 MB
Formato Adobe PDF
2.31 MB Adobe PDF

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1258261
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 27
  • ???jsp.display-item.citation.isi??? 25
social impact