irAEs Associated With Prolonged PFS and OS in NSCLC

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A retrospective study suggested that irAEs with second-line nivolumab are associated with PFS and OS in patients with advanced NSCLC.
A retrospective study suggested that irAEs with second-line nivolumab are associated with PFS and OS in patients with advanced NSCLC.
The following article features coverage from the International Association for the Study of Lung Cancer (IASLC) 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

Immune-related adverse events (irAEs) related to treatment with nivolumab were associated with better survival among patients with advanced non-small cell lung cancer (NSCLC), according to a retrospective study presented at the IASLC's 19th World Conference on Lung Cancer in Toronto, Canada.1

“This is the largest study to date aimed to evaluate whether the development of irAEs is predictive of nivolumab efficacy in pretreated NSCLC patients,” the investigators wrote.

PD-1/PD-L1 inhibitors prolong survival for some patients with advanced NSCLC, but can cause the development of irAEs. The aim of this study was to determine if nivolumab efficacy was associated with irAEs, which were defined as adverse events with an immunologic mechanism that required monitoring and intervention.

This multicenter retrospective study included 195 patients with advanced NSCLC with a median age of 63 years and who were 66% male. irAEs of any grade developed in 44% of patients, and 7.6% of patients experienced grade 3 or grade 4 events.

irAEs were significantly associated with prolonged median progression-free survival (PFS) at 5.7 months compared with 2 months in patients who did not experience irAEs (P < .0001), which corresponded to a hazard ratio (HR) of 0.48 (95% CI, 0.34-0.77; P < .0001) with multivariate analysis. The number of irAEs that developed was also associated with prolonged PFS; patients with at least 2 irAEs, or with 1 irAE, demonstrated a median PFS of 8.5 and 4.6 months, respectively. This was compared with 2 months in patients who had no signs of irAEs (P < .0001).

Overall survival (OS) was also better among patients with irAEs. The median OS was 17.8 months with irAEs compared with 4.04 months without irAEs (P < .0001), corresponding to an HR of 0.38 (95% CI, 0.26-0.56; P < .0001) with multivariate analysis. Patients with at least 2 irAEs or 1 irAE had a median OS of 26.8 months and 11.9 months, respectively, compared with a median OS of 4.04 months in patients with no irAEs (P < .0001).

According to the investigators, the results from this study suggest that “the development of irAEs was a strong predictor of survival outcomes in NSCLC patients who had received nivolumab in the ≥2 line setting.”

Read more of Cancer Therapy Advisor's coverage of the IASLC 2018 meeting by visiting the conference page.

Reference

  1. Ricciuti B, Genova C, De Gilgio A, et al. Impact of immune-related adverse events on survival in patients with advanced non-small cell lung cancer treated with nivolumab. Presented at: International Association for the Study of Lung Cancer 19th World Conference on Lung Cancer; Toronto, Canada; September 23-26, 2018. Abstract MA10.06.

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