Anpalakhan, Shobana, Huddar, Prerana, Behrouzi, Roya, Signori, Alessio, Cave, Judith, Comins, Charles, Cortellini, Alessio, Addeo, Alfredo, Escriu, Carles 
ORCID: 0000-0003-3638-3202, McKenzie, Hayley et al (show 9 more authors)
(2023)
Immunotherapy-related adverse events in real-world patients with advanced non-small cell lung cancer on chemoimmunotherapy: a Spinnaker study sub-analysis.
FRONTIERS IN ONCOLOGY, 13.
1163768-.
Abstract
<h4>Background</h4>The Spinnaker study evaluated survival outcomes and prognostic factors in patients with advanced non-small-cell lung cancer receiving first-line chemoimmunotherapy in the real world. This sub-analysis assessed the immunotherapy-related adverse effects (irAEs) seen in this cohort, their impact on overall survival (OS) and progression-free survival (PFS), and related clinical factors.<h4>Methods</h4>The Spinnaker study was a retrospective multicentre observational cohort study of patients treated with first-line pembrolizumab plus platinum-based chemotherapy in six United Kingdom and one Swiss oncology centres. Data were collected on patient characteristics, survival outcomes, frequency and severity of irAEs, and peripheral immune-inflammatory blood markers, including the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII).<h4>Results</h4>A total of 308 patients were included; 132 (43%) experienced any grade irAE, 100 (32%) Grade 1-2, and 49 (16%) Grade 3-4 irAEs. The median OS in patients with any grade irAES was significantly longer (17.5 months [95% CI, 13.4-21.6 months]) than those without (10.1 months [95% CI, 8.3-12.0 months]) (p<0.001), either if Grade 1-2 (p=0.003) or Grade 3-4 irAEs (p=0.042). The median PFS in patients with any grade irAEs was significantly longer (10.1 months [95% CI, 9.0-11.2 months]) than those without (6.1 months [95% CI, 5.2-7.1 months]) (p<0.001), either if Grade 1-2 (p=0.011) or Grade 3-4 irAEs (p=0.036). A higher rate of irAEs of any grade and specifically Grade 1-2 irAEs correlated with NLR <4 (p=0.013 and p=0.018), SII <1,440 (p=0.029 ad p=0.039), response to treatment (p=0.001 and p=0.034), a higher rate of treatment discontinuation (p<0.00001 and p=0.041), and the NHS-Lung prognostic classes (p=0.002 and p=0.008).<h4>Conclusions</h4>These results confirm survival outcome benefits in patients with irAEs and suggest a higher likelihood of Grade 1-2 irAEs in patients with lower NLR or SII values or according to the NHS-Lung score.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | immune-related adverse effects, immunotherapy, lung cancer, neutrophil-to-lymphocyte ratio (NLR), non-small cell lung cancer, overall survival, progression free survival, systemic immune-inflammation index (SII) |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences > School of Medicine Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 27 Sep 2023 11:04 |
| Last Modified: | 27 Sep 2023 11:04 |
| DOI: | 10.3389/fonc.2023.1163768 |
| Open Access URL: | https://doi.org/10.3389/fonc.2023.1163768 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3173119 |
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