Clinical Outcomes of Patients With Metastatic NSCLC After Discontinuation of Immunotherapy Because of Immune-Related Adverse Effects
Introduction: Immune checkpoint inhibition (ICI) is an important treatment modality in metastatic NSCLC and management of immunotherapy-related adverse effects (irAEs) can be challenging. Retreatment after discontinuation of ICI because of irAEs is a frequent clinical dilemma with limited available...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | JTO Clinical and Research Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364322001655 |
| _version_ | 1797938735094956032 |
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| author | Lysanne A. Lievense, MD, PhD Peter Heukels, MD, PhD Nico C. van Walree, MD Cor H. van der Leest, MD, PhD |
| author_facet | Lysanne A. Lievense, MD, PhD Peter Heukels, MD, PhD Nico C. van Walree, MD Cor H. van der Leest, MD, PhD |
| author_sort | Lysanne A. Lievense, MD, PhD |
| collection | DOAJ |
| description | Introduction: Immune checkpoint inhibition (ICI) is an important treatment modality in metastatic NSCLC and management of immunotherapy-related adverse effects (irAEs) can be challenging. Retreatment after discontinuation of ICI because of irAEs is a frequent clinical dilemma with limited available data. Methods: This single-center retrospective observational study reviewed the clinical course of 30 patients with metastatic NSCLC in whom ICI had to be discontinued owing to a serious irAE after an initial objective response to therapy. Results: After ICI discontinuation, 14 patients (47%) developed a durable response of more than 6 months, seven patients (23%) developed oligoprogression treated with local radiotherapy leading to disease control, six patients (20%) had progression of disease within 6 months, and three patients (10%) died owing to a severe irAE. Conclusions: A watchful waiting approach is justified after discontinuation of ICI owing to irAEs in patients with metastatic NSCLC with an initial response to therapy. |
| first_indexed | 2024-04-10T19:04:20Z |
| format | Article |
| id | doaj.art-3dd65decf6dd4073a810a737dd461e0d |
| institution | Directory Open Access Journal |
| issn | 2666-3643 |
| language | English |
| last_indexed | 2024-04-10T19:04:20Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj.art-3dd65decf6dd4073a810a737dd461e0d2023-01-31T04:09:35ZengElsevierJTO Clinical and Research Reports2666-36432023-01-0141100441Clinical Outcomes of Patients With Metastatic NSCLC After Discontinuation of Immunotherapy Because of Immune-Related Adverse EffectsLysanne A. Lievense, MD, PhD0Peter Heukels, MD, PhD1Nico C. van Walree, MD2Cor H. van der Leest, MD, PhD3Corresponding author. Address for correspondence: Lysanne A. Lievense, MD, PhD, Department of Pulmonary Medicine, Amphia Hospital, Molengracht 21, 4818 CK Breda, The Netherlands.; Department of Pulmonary Medicine, Amphia Hospital, Breda, The NetherlandsDepartment of Pulmonary Medicine, Amphia Hospital, Breda, The NetherlandsDepartment of Pulmonary Medicine, Amphia Hospital, Breda, The NetherlandsDepartment of Pulmonary Medicine, Amphia Hospital, Breda, The NetherlandsIntroduction: Immune checkpoint inhibition (ICI) is an important treatment modality in metastatic NSCLC and management of immunotherapy-related adverse effects (irAEs) can be challenging. Retreatment after discontinuation of ICI because of irAEs is a frequent clinical dilemma with limited available data. Methods: This single-center retrospective observational study reviewed the clinical course of 30 patients with metastatic NSCLC in whom ICI had to be discontinued owing to a serious irAE after an initial objective response to therapy. Results: After ICI discontinuation, 14 patients (47%) developed a durable response of more than 6 months, seven patients (23%) developed oligoprogression treated with local radiotherapy leading to disease control, six patients (20%) had progression of disease within 6 months, and three patients (10%) died owing to a severe irAE. Conclusions: A watchful waiting approach is justified after discontinuation of ICI owing to irAEs in patients with metastatic NSCLC with an initial response to therapy.http://www.sciencedirect.com/science/article/pii/S2666364322001655Non–small cell lung cancerImmunotherapyImmune-related adverse effectsClinical outcomes |
| spellingShingle | Lysanne A. Lievense, MD, PhD Peter Heukels, MD, PhD Nico C. van Walree, MD Cor H. van der Leest, MD, PhD Clinical Outcomes of Patients With Metastatic NSCLC After Discontinuation of Immunotherapy Because of Immune-Related Adverse Effects JTO Clinical and Research Reports Non–small cell lung cancer Immunotherapy Immune-related adverse effects Clinical outcomes |
| title | Clinical Outcomes of Patients With Metastatic NSCLC After Discontinuation of Immunotherapy Because of Immune-Related Adverse Effects |
| title_full | Clinical Outcomes of Patients With Metastatic NSCLC After Discontinuation of Immunotherapy Because of Immune-Related Adverse Effects |
| title_fullStr | Clinical Outcomes of Patients With Metastatic NSCLC After Discontinuation of Immunotherapy Because of Immune-Related Adverse Effects |
| title_full_unstemmed | Clinical Outcomes of Patients With Metastatic NSCLC After Discontinuation of Immunotherapy Because of Immune-Related Adverse Effects |
| title_short | Clinical Outcomes of Patients With Metastatic NSCLC After Discontinuation of Immunotherapy Because of Immune-Related Adverse Effects |
| title_sort | clinical outcomes of patients with metastatic nsclc after discontinuation of immunotherapy because of immune related adverse effects |
| topic | Non–small cell lung cancer Immunotherapy Immune-related adverse effects Clinical outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2666364322001655 |
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