Abstract 2881
Background
Immune-checkpoint inhibitors (ICIs) are a standard-of-care in advanced non-small cell lung cancer (NSCLC). Corticosteroids are often used in symptomatic patients, but their immunosuppressive effect may reduce the efficacy of ICIs. We report our experience in NSCLC and the potential impact of on-treatment use of corticosteroids and antibiotics.
Methods
Medical records of 267 patients with advanced NSCLC receiving ICIs from March 2013 to August 2018 were reviewed. Corticosteroid usage at the time of initiation or during ICIs treatment and administration of antibiotics from 3 months before the initiation of ICIs to 3 months after treatment end were collected. Kaplan Meier and log-rank tests were used to evaluate progression-free (PFS) and overall survival (OS). A multivariable analysis was performed to study the influence of clinical characteristics on treatment efficacy.
Results
146 patients (55%) received corticosteroids: 43% for the treatment of irAEs and 57% for the management of baseline conditions. Prednisone (40%) and dexamethasone (35%) were the most commonly used. Median dose of prednisone equivalent was 50mg daily, 92% received ≥10mg prednisone equivalent daily. Median duration of corticosteroids was 59 days. OS was longer in the group that did not receive corticosteroids or received <10mg prednisone equivalent daily: 14.7 vs 8.3 months. No differences in PFS were observed: 4.6 vs 4.2 months. Patients with corticosteroids for baseline condition presented shorter median OS than the rest of the population: 6.5 vs 16.5 months. Multivariable analysis identified corticosteroids usage as an independent variable related to poorer outcomes. 141 patients (52.8%) received antibiotics. Quinolone (37%) and penicillin (33%) were the most commonly used. No correlation between the usage of antibiotics and efficacy of ICIs was found, with median OS of 10.2 vs 12.5 months.
Conclusions
The use of ≥ 10mg of prednisone equivalent daily was associated with poorer outcomes, especially when given for baseline condition. No correlation was found between antibiotics and survival. Corticosteroids usage may identify a population with higher volume and aggressive tumors. Prudent use of corticosteroids needs to be warranted.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2888 - Development and validation a nomogram based on pathological microscopic features to predict survival in nasopharyngeal carcinoma and guide treatment decision
Presenter: Kuiyuan Liu
Session: Poster Display session 3
Resources:
Abstract
3607 - Deep learning in nasopharyngeal carcinoma: a retrospective cohort study of 3D convolutional neural networks on magnetic resonance imaging
Presenter: Meng Yun Qiang
Session: Poster Display session 3
Resources:
Abstract
5848 - Combined androgen blockade in patients with advanced androgen receptor–positive salivary gland carcinoma: Exploratory biomarker analyses
Presenter: Chihiro Fushimi
Session: Poster Display session 3
Resources:
Abstract
4484 - Classification of esthesioneuroblastoma (ENB) based on chromosome (chr) arm gain and loss (CNA) in the setting of a hypomutated genomic landscape
Presenter: Russell Madison
Session: Poster Display session 3
Resources:
Abstract
5753 - Trastuzumab plus docetaxel in patients with advanced HER2–positive salivary duct carcinoma: Exploratory biomarker analyses
Presenter: Hideaki Takahashi
Session: Poster Display session 3
Resources:
Abstract
3373 - Development and characterization of salivary gland cancer organoid cultures
Presenter: Wim Boxtel
Session: Poster Display session 3
Resources:
Abstract
3118 - A parent-of-origin effect of the RB1 mutations in retinoblastoma with low penetrance and variable expressivity
Presenter: Ekaterina Alekseeva
Session: Poster Display session 3
Resources:
Abstract
4512 - The humanistic burden reported by patients diagnosed with Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck (R/M SCCHN) in Europe
Presenter: Prianka Singh
Session: Poster Display session 3
Resources:
Abstract
3961 - Concurrent Chemotherapy and External Radiation Therapy: An Open Label Non-Inferiority Phase III Randomized Controlled Trial of Weekly versus Three Weekly Cisplatin and Radical Radiotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma: CONCERT trial
Presenter: ATUL SHARMA
Session: Poster Display session 3
Resources:
Abstract
3973 - A randomized phase II study on the OPTimization of IMmunotherapy in squamous carcinoma of the head and neck (SCCHN) – OPTIM (AIO-KHT-0117)
Presenter: Viktor Grünwald
Session: Poster Display session 3
Resources:
Abstract