Risk of Developing Checkpoint Immune Pneumonitis and Its Effect on Overall Survival in Non-small Cell Lung Cancer Patients Previously Treated With Radiotherapy

Frontiers in Oncology

Carolina Blanco¹  Andrés F. Cardona²  Roberto Sánchez⁵  Rodrigo Catalán⁵  Diana Flores-Estrada⁵  Maritza Ramos-Ramírez⁵  Oscar Arrieta⁵  Feliciano Barrón⁵  Zyanya L. Zatarain-Barrón⁵  Marisol Arroyo-Hernández⁵ 

[1] Cancer Center, ABC Medical Center, México City, Mexico;Clinical Research and Biology Systems Department, Universidad el Bosque, Bogotá, Colombia;Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia;Foundation for Clinical and Applied Cancer Research – FICMAC, Bogotá, Colombia;Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, Mexico;

关键词: checkpoint immune therapy;    pneumonitis;    radiotherapy;    NSCLC;    lung cancer;    immune related adverse effects;   

DOI  :  10.3389/fonc.2020.570233

来源: DOAJ

【 摘 要 】

IntroductionImmune checkpoint inhibitor-related pneumonitis (ICIP) is a potentially life threatening immune-related adverse event (irAE), especially in non-small cell lung cancer (NSCLC) patients. Currently, the potential for increased irAE in patients who receive radiotherapy is scarcely known, although a connection between antitumor immune responses and irAEs has been suggested. In this study, we evaluated the development of ICIP in non-small cell lung cancer patients with prior radiotherapy, treated with immunotherapy in the second-line.MethodsIn this retrospective trial, we included patients treated with second-line immunotherapy at the National Cancer Institute in Mexico City from February 2015 to February 2018. Clinical, radiological and treatment variables were evaluated according to the presence of ICIP as defined by the Common Terminology Criteria for Adverse Events (4.0) in patients with or without a previous (≥months) history of radiotherapy.ResultsAmong 101 NSCLC patients who received treatment with ICIs, 22 patients (21.8%) were diagnosed with ICIP, of which 73% (16/22) had a history of radiotherapy (OR 6.04, 95% CI 2.03−18.0, p < 0.001). Median progression free survival and overall survival were similar in patients who developed ICIP compared with those who did not, however, patients who presented grade ≥ 2 ICIP had an increased risk of mortality (HR 2.54, 95% CI 1.20−5.34, p = 0.014).ConclusionIn this real-world cohort of NSCLC patients treated with ICI, the history of prior radiotherapy was associated with increased risk for ICIP development. Unlike other irAEs, grade ≥ 2 ICIP is an independent prognostic factor for decreased survival in NSCLC patients.

【 授权许可】

Unknown