The Oncologist · 2019 · 221 citations · 24 references
Life SciencesImmunologyOncologyAutoimmunityCancer ImmunologyImmunotherapyAutoimmune DiseasesCancer ImmunotherapyCheckpoint Inhibitor TherapyImmune Checkpoint InhibitorsImmune Checkpoint RegulationImmune-related Adverse EventsImmune Checkpoint Inhibitor TherapyImmune-mediated Adverse EventsNon-small Cell Lung Cancer ImmunotherapyNon-small Cell Lung Cancer TherapyNon-small Cell Lung Cancer TreatmentProgrammed Cell Death Protein 1 (Pd-1) PathwayProgrammed Death-1 BlockadeProgrammed Death-1 Inhibition
BACKGROUND: Patients with a history of autoimmune diseases (AIDs) have not usually been included in clinical trials with immune checkpoint inhibitors. MATERIALS AND METHODS: Consecutive patients with advanced cancer, treated with anti-programmed death-1 (PD-1) agents, were evaluated according to the presence of pre-existing AIDs. The incidence of immune-related adverse events (irAEs) and clinical outcomes were compared among subgroups. RESULTS: = .0030) were significantly related to a higher incidence of irAEs of any grade. No significant differences were observed regarding grade 3/4 irAEs and objective response rate among subgroups. Pre-existing AIDs were not significantly related with progression-free survival and overall survival. CONCLUSION: This study quantifies the increased risk of developing irAEs in patients with pre-existing AIDs who had to be treated with anti-PD-1 immunotherapy. Nevertheless, the incidence of grade 3/4 irAEs is not significantly higher when compared with control population. The finding of a greater incidence of irAEs among female patients ranks among the "hot topics" in gender-related differences in immuno-oncology. IMPLICATIONS FOR PRACTICE: Patients with a history of autoimmune diseases (AIDs) have not usually been included in clinical trials with immune checkpoint inhibitors but are frequent in clinical practice. This study quantifies the increased risk of developing immune-related adverse events (irAEs) in patients with pre-existing AIDs who had to be treated with anti-programmed death-1 immunotherapy. Nevertheless, their toxicities are mild and the incidence of grade 3/4 irAEs is not significantly higher compared with those of controls. These results will help clinicians in everyday practice, improving their ability to offer a proper counselling to patients, in order to offer an immunotherapy treatment even to patients with pre-existing autoimmune disease.
24
New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1)
E. Eisenhauer, P. Therasse, Jan Bogaerts et al. · European Journal of Cancer · 2008 · 29.5K citations