Impact of concomitant medication on clinical outcomes in patients with advanced non‐small cell lung cancer treated with immune checkpoint inhibitors: A retrospective study

Thoracic Cancer

Kazuhiko Hanada¹  Takaya Ikeda²  Yoshitaka Zenke²  Hibiki Udagawa²  Keisuke Kirita²  Kaname Nosaki²  Kiyotaka Yoh²  Koichi Goto²  Seiji Niho²  Shingo Matsumoto²  Yoshiyuki Sano³  Kaho Miura³  Kenji Kawasumi³  Toshikatsu Kawasaki³  Nobuo Mochizuki³ 

[1] Department of Pharmacometrics and Pharmacokinetics Meiji Pharmaceutical University Tokyo Japan;Department of Thoracic Oncology National Cancer Center Hospital East Chiba Japan;Division of Pharmacy National Cancer Center Hospital East Chiba Japan;

关键词: concomitant medication;    immune checkpoint inhibitors;    immune‐related adverse events;    non‐small cell lung cancer;    opioids;   

DOI  :  10.1111/1759-7714.14001

来源: DOAJ

【 摘 要 】

Abstract Background It has recently been suggested that concomitant medication may affect the clinical outcome of patients treated with immune checkpoint inhibitors (ICIs). However, only a few studies on the impact of concomitant medication on immune‐related adverse events (irAEs) have previously been reported. Here, we aimed to determine the impact of concomitant medication on the efficacy and safety of ICIs. Methods We retrospectively analyzed the data of 300 patients treated with nivolumab or pembrolizumab for advanced non‐small cell lung cancer (NSCLC) between January 2016 and July 2018. Multivariate logistic regression analysis was used to assess the effect of concomitant medication on treatment response or irAEs. A multivariate Cox proportional hazards model was used to evaluate concomitant medication‐related factors associated with time‐to‐treatment failure or overall survival (OS). Results A total of 70 patients responded to treatment and 137 experienced irAEs. The response rate and incidence of irAEs in patients treated with ICIs were not significantly associated with concomitant medication. Multivariate analysis showed that the use of opioids was an independent factor (time‐to‐treatment failure: hazard ratio 1.39, p = 0.021, OS: hazard ratio 1.54, p = 0.007). Conclusions The efficacy and safety of nivolumab or pembrolizumab in the treatment of patients with advanced NSCLC were not significantly influenced by concomitant medication. However, opioid usage might be associated with shorter OS in patients treated with these ICIs. Further mechanistic investigations should explore whether these associations are purely prognostic or contribute to ICI resistance.

【 授权许可】

Unknown