ICI Therapy Linked To A Reduced Risk Of Second Primary Cancers

Author: By Lynda Williams, Senior medwireNews Reporter 

medwireNews: Patients given immune checkpoint inhibitors (ICIs) may have a reduced risk of developing a second primary cancer, clinicians from the Centre Léon Bérard in Lyon, France, have found. 

Jean-Yves Blay and co-workers reviewed the medical records of 46,829 patients attending the institution between 2013 and 2018 with primary tumours, most commonly of the breast (25%), lung (10%) and head and neck (7%), or the gynaecological (7%) or gastrointestinal (6%) systems. 

A second primary cancer was diagnosed in 3.9% of the cohort after a median of 11.1 months, they write in a letter to the Annals of Oncology. 

Overall, 2.5% of patients in the database received ICI therapy and analysis indicated that these individuals were significantly less likely to be diagnosed with a second primary tumour than those who did not receive immunotherapy, with rates of 0.6% versus 4.0%. 

The authors state that multivariate analysis showed that a reduced incidence of the second primary cancer was independently and significantly associated with young age, metastasis at time of first primary cancer diagnosis, the histotype of the first tumour and use of ICIs. 

“These results are consistent across all histotypes and significant for each individual year of the study”, they emphasize. 

Moreover, when the researchers analysed data for only the 24,356 patients without metastases from their first primary cancer, none of the 1277 individuals who developed a second primary cancer had received immunotherapy, a statistically significant finding. 

In this subgroup, a reduced risk of a second primary cancer was again significantly predicted by young age, first tumour histotype and use of ICI therapy. 

“These observations are consistent with meta-analysis of clinical trials of ICI where no or very few [second primary cancers] were reported”, the team comments. 

Jean-Yves Blay et al say that “longer follow-up will establish whether this reduction is sustained over time” but suggest that “[i]f confirmed, these results open a novel area of clinical research in tertiary prevention for cancer patients.” 

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group 

Reference 

Heudel P, Chabaud S, Perol D, Ray-Coquard I, Blay J-Y. Reduced risk of second primary cancer in patients treated with immune checkpoint inhibitors for a first cancer. Ann Oncol; Advance online publication 8 September 2020. doi:10.1016/j.annonc.2020.09.001