Immunotherapy-related adverse events in real-world patients with advanced non-small cell lung cancer on chemoimmunotherapy: a Spinnaker study sub-analysis
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Authors
Anpalakhan, S.Huddar, Prerana
Behrouzi, Roya
Signori, A.
Cave, J.
Comins, C.
Cortellini, A.
Addeo, A.
Escriu, C.
McKenzie, H.
Barone, G.
Murray, L.
Pinato, D. J.
Ottensmeier, C.
Campos, S.
Muthuramalingam, S.
Chan, S.
Gomes, Fabio
Banna, G. L.
Affiliation
Portsmouth Hospitals University NHS Trust, Portsmouth, United KingdomIssue Date
2023
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Background: The Spinnaker study evaluated survival outcomes and prognostic factors in patients with advanced non-small-cell lung cancer receiving first-line chemoimmunotherapy in the real world. This sub-analysis assessed the immunotherapy-related adverse effects (irAEs) seen in this cohort, their impact on overall survival (OS) and progression-free survival (PFS), and related clinical factors. Methods: The Spinnaker study was a retrospective multicentre observational cohort study of patients treated with first-line pembrolizumab plus platinum-based chemotherapy in six United Kingdom and one Swiss oncology centres. Data were collected on patient characteristics, survival outcomes, frequency and severity of irAEs, and peripheral immune-inflammatory blood markers, including the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII). Results: A total of 308 patients were included; 132 (43%) experienced any grade irAE, 100 (32%) Grade 1-2, and 49 (16%) Grade 3-4 irAEs. The median OS in patients with any grade irAES was significantly longer (17.5 months [95% CI, 13.4-21.6 months]) than those without (10.1 months [95% CI, 8.3-12.0 months]) (p<0.001), either if Grade 1-2 (p=0.003) or Grade 3-4 irAEs (p=0.042). The median PFS in patients with any grade irAEs was significantly longer (10.1 months [95% CI, 9.0-11.2 months]) than those without (6.1 months [95% CI, 5.2-7.1 months]) (p<0.001), either if Grade 1-2 (p=0.011) or Grade 3-4 irAEs (p=0.036). A higher rate of irAEs of any grade and specifically Grade 1-2 irAEs correlated with NLR <4 (p=0.013 and p=0.018), SII <1,440 (p=0.029 ad p=0.039), response to treatment (p=0.001 and p=0.034), a higher rate of treatment discontinuation (p<0.00001 and p=0.041), and the NHS-Lung prognostic classes (p=0.002 and p=0.008). Conclusions: These results confirm survival outcome benefits in patients with irAEs and suggest a higher likelihood of Grade 1-2 irAEs in patients with lower NLR or SII values or according to the NHS-Lung score.Citation
Anpalakhan S, Huddar P, Behrouzi R, Signori A, Cave J, Comins C, et al. Immunotherapy-related adverse events in real-world patients with advanced non-small cell lung cancer on chemoimmunotherapy: a Spinnaker study sub-analysis. Frontiers in oncology. 2023;13:1163768. PubMed PMID: 37324003. Pubmed Central PMCID: PMC10265987. Epub 2023/06/16. eng.Journal
Frontiers in OncologyDOI
10.3389/fonc.2023.1163768PubMed ID
37324003Additional Links
https://dx.doi.org/10.3389/fonc.2023.1163768Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.3389/fonc.2023.1163768