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- Title
Effects of Early Short-Course Corticosteroids on Immune-Related Adverse Events in Non-Small Cell Lung Cancer Patients Receiving Immune Checkpoint Inhibitors.
- Authors
Huang, Derek De-Rui; Liao, Bin-Chi; Hsu, Wei-Hsun; Yang, Ching-Yao; Lin, Yen-Ting; Wu, Shang-Gin; Tsai, Tzu-Hsiu; Chen, Kuan-Yu; Ho, Chao-Chi; Liao, Wei-Yu; Shih, Jin-Yuan; Yu, Chong-Jen; Yang, James Chih-Hsin; Cheng, Ann-Lii; Shen, Ying-Chun
- Abstract
Introduction: In real-world practice, most non-small cell lung cancer (NSCLC) patients receiving combined immunochemotherapy are exposed to short-course corticosteroids following immune checkpoint inhibitor (ICI) infusion to prevent chemotherapy-related adverse events. However, whether this early short-course corticosteroid use prevents immune-related adverse events (irAEs) remains unknown. Methods: Between January 1st, 2015, and December 31st, 2020, NSCLC patients who received at least one cycle of ICI with or without chemotherapy were enrolled. Early short-course corticosteroids were defined as corticosteroids administered following ICI injection and before chemotherapy on the same day and no longer than 3 days afterward. The patients were categorized as either "corticosteroid group" or "non-corticosteroid group" depending on their exposure to early short-course corticosteroid. The frequencies of irAEs requiring systemic corticosteroid use and irAEs leading to ICI discontinuation were compared between the two groups, and exploratory survival analyses were performed. Results: Among 252 eligible patients, 137 patients were categorized as "corticosteroid group" and 115 patients as "non-corticosteroid group." The corticosteroid group enriched patients in the first-line setting (n = 75, 54.7%), compared to the non-corticosteroid group (n = 28, 24.3%). Thirty patients (21.9%) in the corticosteroid group and 35 patients (30.4%) in the non-corticosteroid group developed irAEs requiring systemic corticosteroid use (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.35–1.18; p = 0.15). Eight patients (5.8%) in the corticosteroid group, as compared with 18 patients (15.7%) in the non-corticosteroid group, permanently discontinued ICI due to irAEs (OR, 0.34; 95% CI, 0.12–0.85; p = 0.013). Conclusion: Early short-course corticosteroids following each ICI injection may reduce the rate of irAEs that lead to ICIs discontinuation, warranting further investigation of its prophylactic use to mitigate clinically significant irAEs.
- Subjects
TAIWAN; CHEST physiology; ADRENOCORTICAL hormones; COMBINATION drug therapy; DRUG side effects; ANTINEOPLASTIC agents; IMMUNOTHERAPY; TREATMENT effectiveness; RETROSPECTIVE studies; DESCRIPTIVE statistics; IMMUNE checkpoint inhibitors; LONGITUDINAL method; CANCER chemotherapy; ODDS ratio; LUNG tumors; RESEARCH; LUNG cancer; CANCER patient psychology; SURVIVAL analysis (Biometry); COMPARATIVE studies; CONFIDENCE intervals
- Publication
Oncology, 2024, Vol 102, Issue 4, p318
- ISSN
0030-2414
- Publication type
Article
- DOI
10.1159/000534350