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Vol.59 No.2 contents Japanese/English

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Article in Japanese

- Original Article -

The Impact of Immune-related Adverse Events on the Effect of Immune Checkpoint Inhibitors in Non-small Cell Lung Cancer

Keiko Tanimura1, Tadaaki Yamada1, Yusuke Chihara1, Yutaka Kubota2, Shinsuke Shiotsu3, Takayuki Takeda4, Takahiro Yamada5, Osamu Hiranuma6, Junji Uchino1, Koichi Takayama1
1Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Japan, 2Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Japan, 3Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Japan, 4Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Japan, 5Department of Respiratory Medicine, Matsushita Memorial Hospital, Japan, 6Department of Respiratory Medicine, Otsu City Hospital, Japan

Background. Immune checkpoint inhibitors (ICIs) are a standard therapy for patients with advanced non-small cell lung cancer (NSCLC). Immune-related adverse events (irAEs) are occasionally caused by treatment with ICIs. The association between the emergence of irAEs and a beneficial outcome with immunotherapy was reported in patients with NSCLC. Study Design. This retrospective study analyzed 146 patients with advanced NSCLC who were treated with ICIs between January 2016 and December 2017 at 6 institutions in Japan. The association between the emergence of irAEs and patients' clinical features was investigated. Results. A total of 58 patients (39.7%) developed irAEs, while 88 (60.3%) did not. The response rates were higher in NSCLC patients with irAEs than in those without irAEs (36.2% vs. 14.8%). The disease control rate was higher in NSCLC patients with irAEs than in those without irAEs (70.7% vs. 34.1%). The progression-free survival with ICI treatment was longer in NSCLC patients with irAEs than in those without irAEs (4.9 months vs. 2.1 months, p = 0.0178). The overall survival with ICI treatment was longer in NSCLC patients with irAEs than in those without irAEs (17.8 months vs. 11.3 months, p = 0.0286). NSCLC patients who developed irAEs ≥42 days of the initiation of ICIs showed a longer survival and a higher response rate than those who developed irAEs <42 days of starting treatment. Conclusion. These results showed that NSCLC patients with irAEs had superior clinical outcomes of ICI treatment to those without irAEs. Furthermore, the onset timing of irAE may influence the clinical outcomes of ICI treatment.
key words: Immune checkpoint inhibitor, Non-small cell lung cancer, Immune-related adverse event, Biomarker

Received: October 17, 2018
Accepted: February 4, 2019

JJLC 59 (2): 128-136, 2019

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