Association of Systemic Steroid Treatment and Outcome in Patients Treated with Immune Checkpoint Inhibitors: A Real-World Analysis
Background: Immune-related adverse events (irAEs) are inflammatory side effects, which can occur during immune-checkpoint(s) inhibitors (ICIs) therapy. Steroids are the first-line agents to manage irAEs because of their immunosuppressive properties. However, it is still debated whether or when stero...
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| Format: | Article |
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MDPI AG
2021-09-01
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| Series: | Molecules |
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| Online Access: | https://www.mdpi.com/1420-3049/26/19/5789 |
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| author | Agnese Paderi Elisabetta Gambale Cristina Botteri Roberta Giorgione Daniele Lavacchi Marco Brugia Francesca Mazzoni Elisa Giommoni Susanna Bormioli Amedeo Amedei Serena Pillozzi Marco Matucci Cerinic Lorenzo Antonuzzo |
| author_facet | Agnese Paderi Elisabetta Gambale Cristina Botteri Roberta Giorgione Daniele Lavacchi Marco Brugia Francesca Mazzoni Elisa Giommoni Susanna Bormioli Amedeo Amedei Serena Pillozzi Marco Matucci Cerinic Lorenzo Antonuzzo |
| author_sort | Agnese Paderi |
| collection | DOAJ |
| description | Background: Immune-related adverse events (irAEs) are inflammatory side effects, which can occur during immune-checkpoint(s) inhibitors (ICIs) therapy. Steroids are the first-line agents to manage irAEs because of their immunosuppressive properties. However, it is still debated whether or when steroids can be administered without abrogating the therapeutic efforts of immunotherapy. Methods: We retrospectively evaluated 146 patients with metastatic non-small cell lung cancer (NSCLC), melanoma and renal cell carcinoma (RCC) treated with ICIs. We assessed the progression-free survival (PFS) of patients treated with steroids due to an irAE compared to a no-steroid group. Results: The early treatment with steroid (within the first 30 days from the beginning of immunotherapy) was not related to a shorter PFS (<i>p</i> = 0.077). Interestingly, patients who were treated with steroids after 30 days from the start of immunotherapy had significantly longer PFS (<i>p</i> = 0.017). In a multivariate analysis, treatment with steroids after 30 days was an independent prognostic factor for PFS (HR: 0.59 [95% CI 0.36–0.97], <i>p</i> = 0.037). Conclusions: This retrospective study points out that early systemic steroids administration to manage irAEs might not have a detrimental effect on patient clinical outcome in NSCLC, melanoma and RCC patients. |
| first_indexed | 2024-03-10T06:55:08Z |
| format | Article |
| id | doaj.art-906a6d089ec74a23a9c8288953790419 |
| institution | Directory Open Access Journal |
| issn | 1420-3049 |
| language | English |
| last_indexed | 2024-03-10T06:55:08Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Molecules |
| spelling | doaj.art-906a6d089ec74a23a9c82889537904192023-11-22T16:32:38ZengMDPI AGMolecules1420-30492021-09-012619578910.3390/molecules26195789Association of Systemic Steroid Treatment and Outcome in Patients Treated with Immune Checkpoint Inhibitors: A Real-World AnalysisAgnese Paderi0Elisabetta Gambale1Cristina Botteri2Roberta Giorgione3Daniele Lavacchi4Marco Brugia5Francesca Mazzoni6Elisa Giommoni7Susanna Bormioli8Amedeo Amedei9Serena Pillozzi10Marco Matucci Cerinic11Lorenzo Antonuzzo12Medical Oncology Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, ItalyMedical Oncology Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, ItalyBackground: Immune-related adverse events (irAEs) are inflammatory side effects, which can occur during immune-checkpoint(s) inhibitors (ICIs) therapy. Steroids are the first-line agents to manage irAEs because of their immunosuppressive properties. However, it is still debated whether or when steroids can be administered without abrogating the therapeutic efforts of immunotherapy. Methods: We retrospectively evaluated 146 patients with metastatic non-small cell lung cancer (NSCLC), melanoma and renal cell carcinoma (RCC) treated with ICIs. We assessed the progression-free survival (PFS) of patients treated with steroids due to an irAE compared to a no-steroid group. Results: The early treatment with steroid (within the first 30 days from the beginning of immunotherapy) was not related to a shorter PFS (<i>p</i> = 0.077). Interestingly, patients who were treated with steroids after 30 days from the start of immunotherapy had significantly longer PFS (<i>p</i> = 0.017). In a multivariate analysis, treatment with steroids after 30 days was an independent prognostic factor for PFS (HR: 0.59 [95% CI 0.36–0.97], <i>p</i> = 0.037). Conclusions: This retrospective study points out that early systemic steroids administration to manage irAEs might not have a detrimental effect on patient clinical outcome in NSCLC, melanoma and RCC patients.https://www.mdpi.com/1420-3049/26/19/5789immunotherapyimmune checkpoint inhibitorssteroidirAEsnon-small cell cancerrenal cell cancer |
| spellingShingle | Agnese Paderi Elisabetta Gambale Cristina Botteri Roberta Giorgione Daniele Lavacchi Marco Brugia Francesca Mazzoni Elisa Giommoni Susanna Bormioli Amedeo Amedei Serena Pillozzi Marco Matucci Cerinic Lorenzo Antonuzzo Association of Systemic Steroid Treatment and Outcome in Patients Treated with Immune Checkpoint Inhibitors: A Real-World Analysis Molecules immunotherapy immune checkpoint inhibitors steroid irAEs non-small cell cancer renal cell cancer |
| title | Association of Systemic Steroid Treatment and Outcome in Patients Treated with Immune Checkpoint Inhibitors: A Real-World Analysis |
| title_full | Association of Systemic Steroid Treatment and Outcome in Patients Treated with Immune Checkpoint Inhibitors: A Real-World Analysis |
| title_fullStr | Association of Systemic Steroid Treatment and Outcome in Patients Treated with Immune Checkpoint Inhibitors: A Real-World Analysis |
| title_full_unstemmed | Association of Systemic Steroid Treatment and Outcome in Patients Treated with Immune Checkpoint Inhibitors: A Real-World Analysis |
| title_short | Association of Systemic Steroid Treatment and Outcome in Patients Treated with Immune Checkpoint Inhibitors: A Real-World Analysis |
| title_sort | association of systemic steroid treatment and outcome in patients treated with immune checkpoint inhibitors a real world analysis |
| topic | immunotherapy immune checkpoint inhibitors steroid irAEs non-small cell cancer renal cell cancer |
| url | https://www.mdpi.com/1420-3049/26/19/5789 |
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