Abstract 117P
Background
The treatment standard of cancer has dramatically diverted with immune checkpoint inhibitors (ICI). Despite the proven clinical advantage, some tumors do not respond to ICI. The expression of PD-L1, the tumor microenvironment (TME), and the tumor mutational burden are essential to the success of ICI and are currently considered biomarkers predictive of response. Increased Beta-adrenergic receptor signaling has been shown to promote the creation of an immunosuppressive TME. The annulment of this pathway provides a more responsive TME and may enhance the activity of ICI, and the use of beta-blockade for this purpose has shown conflicting results. We investigated patients with lung cancer who concomitantly used beta-blockers (BB) and ICI, hypothesizing that blocking the beta-adrenergic pathway would impact the outcome.
Methods
We retrospectively reviewed 51 patients treated at our institution for 18 months with ICIs for non-small-cell lung cancer (NSCLC). Comparisons of overall survival and progression-free survival (PFS) were performed using Kaplan-Meier analysis with log-rank test, and a univariate regression analysis was performed with a Cox proportional hazards model.
Results
Among the 51 patients, 11 concomitantly used beta blockers. There was no significant increase in overall survival among patients who took beta-blockers (p=0.83; 95% confidence interval, 0.33-2.47), and BB was not predictive of PFS. Although well established, our study confirmed that elevated levels of lactate dehydrogenase were associated with poorer overall survival (p=0.034, 95% confidence interval 1.000-1.005), and weight loss was predictive of PFS (p=0.019, 95% confidence interval 1.097-2.839).
Conclusions
In summary, this study found no evidence that BBs enhance immunotherapy effectiveness. Despite that, this was a small study, and these results should be validated in prospective clinical studies.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.