Assessment of anti-PD-(L)1 for patients with coexisting malignant tumor and tuberculosis classified by active, latent, and obsolete stage
Abstract Background It is not a rare clinical scenario to have patients presenting with coexisting malignant tumor and tuberculosis. Whether it is feasible to conduct programmed death-(ligand) 1 [PD-(L)1] inhibitors to these patients, especially those with active tuberculosis treated with concurrent...
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-021-02194-z |
| _version_ | 1818969274847330304 |
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| author | Shan Su Mei-Feng Ye Xiao-Ting Cai Xue Bai Zhi-Hao Huang Si-Cong Ma Jian-Jun Zou Yu-Xiang Wen Li-Juan Wu Xue-Jun Guo Xian-Lan Zhang Wen-Chang Cen Duo-Hua Su Hui-Yi Huang Zhong-Yi Dong |
| author_facet | Shan Su Mei-Feng Ye Xiao-Ting Cai Xue Bai Zhi-Hao Huang Si-Cong Ma Jian-Jun Zou Yu-Xiang Wen Li-Juan Wu Xue-Jun Guo Xian-Lan Zhang Wen-Chang Cen Duo-Hua Su Hui-Yi Huang Zhong-Yi Dong |
| author_sort | Shan Su |
| collection | DOAJ |
| description | Abstract Background It is not a rare clinical scenario to have patients presenting with coexisting malignant tumor and tuberculosis. Whether it is feasible to conduct programmed death-(ligand) 1 [PD-(L)1] inhibitors to these patients, especially those with active tuberculosis treated with concurrent anti-tuberculosis, is still unknown. Methods This study enrolled patients with coexisting malignancy and tuberculosis and treated with anti-PD-(L)1 from Jan 2018 to July 2021 in 2 institutions. The progression-free survival (PFS), objective response rate (ORR), and safety of anti-PD-(L)1 therapy, as well as response to anti-tuberculosis treatment, were evaluated. Results A total of 98 patients were screened from this cohort study, with 45 (45.9%), 21 (21.4%), and 32 (32.7%) patients diagnosed with active, latent, and obsolete tuberculosis, respectively. The overall ORR was 36.0% for anti-PD-(L)1 therapy, with 34.2%, 35.5%, and 41.2% for each subgroup. Median PFS was 8.0 vs 6.0 vs 6.0 months (P=0.685) for each subgroup at the time of this analysis. For patients with active tuberculosis treated with concurrent anti-tuberculosis, median duration of anti-tuberculosis therapy was 10.0 (95% CI, 8.01–11.99) months. There were 83.3% (20/24) and 93.3% (42/45) patients showing sputum conversion and radiographic response, respectively, after anti-tuberculosis therapy, and two patients experienced tuberculosis relapse. Notably, none of the patients in latent and only one patient in obsolete subgroups showed tuberculosis induction or relapse after anti-PD-(L)1 therapy. Treatment-related adverse events (TRAEs) occurred in 33 patients (73.3%) when treated with concurrent anti-PD-(L)1 and anti-tuberculosis. Grade 3 or higher TRAEs were hematotoxicity (n = 5, 11.1%), and one patient suffered grade 3 pneumonitis leading to the discontinuation of immunotherapy. Conclusions This study demonstrated that patients with coexisting malignant tumor and tuberculosis benefited equally from anti-PD-(L)1 therapy, and anti-tuberculosis response was unimpaired for those with active tuberculosis. Notably, the combination of anti-PD-(L)1 and anti-tuberculosis therapy was well-tolerated without significant unexpected toxic effects. |
| first_indexed | 2024-12-20T14:17:59Z |
| format | Article |
| id | doaj.art-895224225a4443428766e35a13dfa42b |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-20T14:17:59Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-895224225a4443428766e35a13dfa42b2022-12-21T19:38:00ZengBMCBMC Medicine1741-70152021-12-0119111110.1186/s12916-021-02194-zAssessment of anti-PD-(L)1 for patients with coexisting malignant tumor and tuberculosis classified by active, latent, and obsolete stageShan Su0Mei-Feng Ye1Xiao-Ting Cai2Xue Bai3Zhi-Hao Huang4Si-Cong Ma5Jian-Jun Zou6Yu-Xiang Wen7Li-Juan Wu8Xue-Jun Guo9Xian-Lan Zhang10Wen-Chang Cen11Duo-Hua Su12Hui-Yi Huang13Zhong-Yi Dong14Department of Oncology, Guangzhou Chest HospitalDepartment of Oncology, Guangzhou Chest HospitalDepartment of Radiation Oncology, Nanfang Hospital, Southern Medical UniversityDepartment of Radiation Oncology, Nanfang Hospital, Southern Medical UniversityDepartment of Oncology, Guangzhou Chest HospitalDepartment of Radiation Oncology, Nanfang Hospital, Southern Medical UniversityDepartment of Oncology, Guangzhou Chest HospitalDepartment of Radiation Oncology, Nanfang Hospital, Southern Medical UniversityDepartment of Tuberculosis, Guangzhou Chest HospitalDepartment of Radiation Oncology, Nanfang Hospital, Southern Medical UniversityDepartment of Oncology, Guangzhou Chest HospitalDepartment of Oncology, Guangzhou Chest HospitalDepartment of Tuberculosis, Guangzhou Chest HospitalDepartment of Oncology, Guangzhou Chest HospitalDepartment of Radiation Oncology, Nanfang Hospital, Southern Medical UniversityAbstract Background It is not a rare clinical scenario to have patients presenting with coexisting malignant tumor and tuberculosis. Whether it is feasible to conduct programmed death-(ligand) 1 [PD-(L)1] inhibitors to these patients, especially those with active tuberculosis treated with concurrent anti-tuberculosis, is still unknown. Methods This study enrolled patients with coexisting malignancy and tuberculosis and treated with anti-PD-(L)1 from Jan 2018 to July 2021 in 2 institutions. The progression-free survival (PFS), objective response rate (ORR), and safety of anti-PD-(L)1 therapy, as well as response to anti-tuberculosis treatment, were evaluated. Results A total of 98 patients were screened from this cohort study, with 45 (45.9%), 21 (21.4%), and 32 (32.7%) patients diagnosed with active, latent, and obsolete tuberculosis, respectively. The overall ORR was 36.0% for anti-PD-(L)1 therapy, with 34.2%, 35.5%, and 41.2% for each subgroup. Median PFS was 8.0 vs 6.0 vs 6.0 months (P=0.685) for each subgroup at the time of this analysis. For patients with active tuberculosis treated with concurrent anti-tuberculosis, median duration of anti-tuberculosis therapy was 10.0 (95% CI, 8.01–11.99) months. There were 83.3% (20/24) and 93.3% (42/45) patients showing sputum conversion and radiographic response, respectively, after anti-tuberculosis therapy, and two patients experienced tuberculosis relapse. Notably, none of the patients in latent and only one patient in obsolete subgroups showed tuberculosis induction or relapse after anti-PD-(L)1 therapy. Treatment-related adverse events (TRAEs) occurred in 33 patients (73.3%) when treated with concurrent anti-PD-(L)1 and anti-tuberculosis. Grade 3 or higher TRAEs were hematotoxicity (n = 5, 11.1%), and one patient suffered grade 3 pneumonitis leading to the discontinuation of immunotherapy. Conclusions This study demonstrated that patients with coexisting malignant tumor and tuberculosis benefited equally from anti-PD-(L)1 therapy, and anti-tuberculosis response was unimpaired for those with active tuberculosis. Notably, the combination of anti-PD-(L)1 and anti-tuberculosis therapy was well-tolerated without significant unexpected toxic effects.https://doi.org/10.1186/s12916-021-02194-zMalignant tumor, Tuberculosis, PD1/PD-L1, Efficacy, Safety |
| spellingShingle | Shan Su Mei-Feng Ye Xiao-Ting Cai Xue Bai Zhi-Hao Huang Si-Cong Ma Jian-Jun Zou Yu-Xiang Wen Li-Juan Wu Xue-Jun Guo Xian-Lan Zhang Wen-Chang Cen Duo-Hua Su Hui-Yi Huang Zhong-Yi Dong Assessment of anti-PD-(L)1 for patients with coexisting malignant tumor and tuberculosis classified by active, latent, and obsolete stage BMC Medicine Malignant tumor, Tuberculosis, PD1/PD-L1, Efficacy, Safety |
| title | Assessment of anti-PD-(L)1 for patients with coexisting malignant tumor and tuberculosis classified by active, latent, and obsolete stage |
| title_full | Assessment of anti-PD-(L)1 for patients with coexisting malignant tumor and tuberculosis classified by active, latent, and obsolete stage |
| title_fullStr | Assessment of anti-PD-(L)1 for patients with coexisting malignant tumor and tuberculosis classified by active, latent, and obsolete stage |
| title_full_unstemmed | Assessment of anti-PD-(L)1 for patients with coexisting malignant tumor and tuberculosis classified by active, latent, and obsolete stage |
| title_short | Assessment of anti-PD-(L)1 for patients with coexisting malignant tumor and tuberculosis classified by active, latent, and obsolete stage |
| title_sort | assessment of anti pd l 1 for patients with coexisting malignant tumor and tuberculosis classified by active latent and obsolete stage |
| topic | Malignant tumor, Tuberculosis, PD1/PD-L1, Efficacy, Safety |
| url | https://doi.org/10.1186/s12916-021-02194-z |
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