A study showed that patients who have received immunotherapy for non-small cell lung cancer can get more than one immune relative side effect.
The most common form of lung cancer is non-small cell lung cancer (NSCLC). It is divided into four stages, depending on the lung tumor’s size and location(s). Surgery and chemotherapy are common approaches to treatment, but newer approaches such as targeted therapy and immunotherapy provide promising survival benefits for patients with NSCLC.
A form of immunotherapy that has improved survival rates is immune checkpoint therapy. Immune checkpoints consist of proteins that protect healthy cells from being attacked by T-cells during an immune response; that is, they promote self-tolerance. However, cancer cells are capable of using checkpoint proteins to evade the T-cell attack. Checkpoint inhibitors are drugs that block checkpoint proteins to enhance effective T-cell attack of tumor cells. Given the role of checkpoints in protecting healthy cells, checkpoint inhibitor therapy has been associated with adverse effects due to increased T-cell attack on healthy cells.
Although adverse events often limit the utility or complicate the efficacy and safety of a treatment, researchers have recently found that patients who experience immune-related adverse events (IR-AEs) with checkpoint inhibitor immunotherapy may have better survival outcomes than patients who do not. In a retrospective study, anti-PD-1/anti-PD-L1 immune checkpoint inhibitors were used to treat patients with stage III/IV NSCLC. The researchers analyzed the overall and progression-free survival between patients who had zero to multiple IR-AEs. The IR-AEs consisted of various single or multi-organ inflammatory responses such as pneumonitis, hepatitis, thyroiditis, and dermatitis.
Quite interestingly, those patients who did not experience IR-AEs had lower overall and progression-free survival than those that did, with a higher survival rate that correlated to the number of IR-AEs. For instance, those with one or two IR-AEs had a 1.3- to 2.5-fold increase in overall survival, respectively (1.8- and nearly 4-fold for progression-free survival, respectively) compared to those with no IR-AEs, which was approximately 9 months for overall survival and 2.8 months for progression-free survival. The study results suggest that there is a strong association between the development of multiple IR-AEs and NSCLC survival.
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Emily Henderson, B. (2020). Multisystem immune-related adverse events linked with improved survival from immunotherapy in NSCLC. Retrieved 8 January 2021, from https://www.news-medical.net/news/20201214/Multisystem-immune-related-adverse-events-linked-with-improved-survival-from-immunotherapy-in-NSCLC.aspx