Immune-Related Adverse Events During Anti-PD-1 Therapy May Increase Survival in Head and Neck Cancer

Experiencing immune-related adverse events (irAEs) during the course of anti-programmed death-receptor-1 (PD-1) therapy may be correlated with improved survival and response outcomes among patients with head and neck cancer (HNC), according to findings in poster presentation at the American Society of Clinical Oncology 2018 Annual Meeting on Saturday, June 2.¹

It is thought that immune competence may modify antitumor response with anti-PD-1 therapy. Researchers evaluated whether the development of irAEsc—cdefined as any immune-mediated adverse effects — among patients with metastatic HNC who have failed platinum-based chemotherapy would be associated with improved outcomes.

For this prospective study, investigators identified 114 patients unselected for PD-L1 status and treated them with anti-PD-1 therapy. Median follow-up was 8.9 months. Baseline characteristics, including PD-L1-positivity, were comparable between the two study arms.

Overall, 59 irAEs occurred in 49 of 108 evaluable patients; 20 dermatologic, 15 musculoskeletal, 14 endocrine, 6 hepatic, 2 ophthalmologic, and 1 pulmonary and gastrointestinal iRAEs were reported. Five patients (10.2%) experienced a grade 3 or higher irAE.

The overall response rate (ORR) was 30.6% among patients who experienced irAEs compared with 12.3% among patients who did not develop any irAEs (P = .02). The median progression-free survival (PFS) was 6.9 months and 2.1 months among patients who were irAE-positive and negative, respectively (P = .0004), and the median overall survival (OS) was nearly doubled among patients who were irAE-positive (12.5 months vs 6.8 months; P = .007).

A multivariable analysis revealed that the incidence of irAEs was independently associated with enhanced ORR (P = .03), PFS (P = .009), and OS (P = .003).

The authors concluded that “the ability to develop irAEs may be an indicator of immune competence and determining patient immune competence more accurately may be clinically useful.”

Read more of Cancer Therapy Advisor‘s coverage of the American Society of Clinical Oncology (ASCO) 2018 meeting by visiting the conference page.

Reference

1. Foster CC, Kochanny S, Khattri A, et al. Association of immune-related adverse events (irAEs) with improved response, progression-free survival, and overall survival for patients with metastatic head and neck cancer receiving anti-PD-1 therapy. Poster presentation at: 2018 ASCO Annual Meeting; June 1-5, 2018; Chicago, IL.