The Association of Immune-Related Adverse Events with the Efficacy of Atezolizumab in Previously Treated Advanced Non-Small-Cell Lung Cancer Patients: A Single-Center Experience
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Data
2.3. Statistical Analysis
3. Results
3.1. Patient Characteristics and irAE Profiles
3.2. Association between irAEs and Atezolizumab Efficacy
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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N = 105 | N (%) |
---|---|
Mean age at treatment start (range) [years] | 62.31 (35–82) |
Sex | |
Male | 67 (63.8) |
Female | 38 (36.2) |
Smoking status | |
Current | 56 (53.3) |
Ex-smoker | 39 (37.1) |
Non-smoker | 10 (9.5) |
ECOG PS | |
0–1 | 53 (50.5) |
≥2 | 52 (49.5) |
Histological diagnosis | |
Adenocarcinoma | 59 (56.2) |
Squamous cell carcinoma | 43 (41.9) |
Other (NOS) | 2 (1.9) |
*PD-L1 status | |
50–100% | 13 (12.4) |
1–49% | 27 (25.7) |
<1% | 43 (41) |
No data available | 22 (21) |
Stage at the time of diagnosis | |
IIIB | 16 (15.2) |
IV | 89 (84.8) |
Atezolizumab line of treatment | |
II | 19 (18.1) |
III | 21 (20) |
IV | 46 (43.8) |
V | 18 (17.1) |
VI | 1 (1) |
Mean number of chemotherapy cycles (range) | 10.01 (2–26) |
Immune-related adverse events | 23 (21.9) |
Grade 1–2 | 19 (18.1) |
Grade 3–4 | 4 (3.8) |
No immune-related adverse events | 82 (78.1) |
Best response to atezolizumab (iRECIST) | |
αPD | 48 (45.7) |
βSD | 38 (36.2) |
δPR | 18 (17.1) |
μCR | 1 (1) |
Real world °DCR | 54.3% |
Real world öORR | 18.1% |
Median PFS (95% confidence interval) [months] | 4.67 (1.3–8.02) |
Median overall survival (95% confidence interval) [months] | 35.8 (27.8–43.7) |
Patients with irAE (n = 23) | Patients without irAE (n = 82) | p Value | |
---|---|---|---|
Age | 0.50 | ||
<70 years | 18 (78.3%) | 69 (84.1%) | |
≥70 years | 5 (21.7%) | 13 (15.9%) | |
Sex | 0.02 | ||
Male | 10 (43.5%) | 57 (69.5%) | |
Female | 13 (56.5%) | 25 (30.5%) | |
Histology | 0.43 | ||
Non-squamous | 15 (61.9%) | 46 (56.1%) | |
Squamous | 8 (38.1%) | 36 (43.8%) | |
Smoking status | 0.55 | ||
Current | 12 (52.2%) | 37 (45.1%) | |
Former or never smoker | 11 (47.2%) | 45 (54.9%) | |
PD-L1 status | 0.91 | ||
≥50% | 3 (13%) | 10 (12.2%) | |
<50% or unknown | 20 (87%) | 72 (87.8%) | |
ECOG PS | 0.01 | ||
0–1 | 17 (73.9%) | 36 (43.8%) | |
2 | 6 (26.1%) | 46 (56.2%) | |
Line of treatment | 0.27 | ||
Second and third | 11 (47.2%) | 29 (35.4%) | |
Later | 12 (52.2%) | 53 (64.6%) |
irAE Type | Grade 1–2 | Grade 3–4 |
---|---|---|
Diarrhea | 4 (17.4%) | |
Thyroid toxicities | 4 (17.4%) | |
Skin toxicity | 5 (21.7%) | |
Pneumonitis | 3 (13%) | |
Hepatotoxicity | 1 (4.3%) | 3 (13%) |
General (fatigue) | 2 (8.6%) | 1 (4.3%) |
Immune-Related Adverse Events | ||
---|---|---|
Yes—N (%) | No—N (%) | |
CR | 1 (4.34%) | 0 (0) |
PR | 7 (30.43%) | 11 (13.41%) |
SD | 12 (52.17%) | 27 (32.92%) |
PD | 3 (13.04%) | 45 (54.87%) |
Univariable Regression Analysis | Multivariable Regression Analysis | |||||
---|---|---|---|---|---|---|
HR | 95% CI | p | HR | 95% CI | p | |
Age (<70 years vs. ≥70 years) | 0.991 | 0.562–1.748 | 0.974 | |||
Sex (male vs. female) | 1.083 | 0.676–1.735 | 0.741 | |||
Histology (non-squamous vs. squamous) | 1.056 | 0.674–1.653 | 0.813 | |||
Smoking status (current vs. former or never smoker) | 1.312 | 0.837–2.057 | 0.237 | |||
PD-L1 (≥50% vs. <50% or unknown) | 0.917 | 0.470–1.787 | 0.798 | |||
ECOG PS (0–1 vs. 2) | 7.744 | 4.440–13.508 | <0.001 | 7.124 | 4.061–12.497 | <0.001 |
irAE (yes vs. no) | 0.365 | 0.195–0.681 | 0.002 | 0.457 | 0.242–0.863 | 0.016 |
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Marković, F.; Stjepanović, M.; Samardžić, N.; Kontić, M. The Association of Immune-Related Adverse Events with the Efficacy of Atezolizumab in Previously Treated Advanced Non-Small-Cell Lung Cancer Patients: A Single-Center Experience. Cancers 2024, 16, 2995. https://doi.org/10.3390/cancers16172995
Marković F, Stjepanović M, Samardžić N, Kontić M. The Association of Immune-Related Adverse Events with the Efficacy of Atezolizumab in Previously Treated Advanced Non-Small-Cell Lung Cancer Patients: A Single-Center Experience. Cancers. 2024; 16(17):2995. https://doi.org/10.3390/cancers16172995
Chicago/Turabian StyleMarković, Filip, Mihailo Stjepanović, Natalija Samardžić, and Milica Kontić. 2024. "The Association of Immune-Related Adverse Events with the Efficacy of Atezolizumab in Previously Treated Advanced Non-Small-Cell Lung Cancer Patients: A Single-Center Experience" Cancers 16, no. 17: 2995. https://doi.org/10.3390/cancers16172995