Previous radiotherapy improves treatment responses and causes a trend toward longer time to progression among patients with immune checkpoint inhibitor-related adverse events
Jokimäki, Anna; Hietala, Henna; Lemma, Jasmiini; Karhapää, Hanna; Rintala, Anna; Kaikkonen, Jari Pekka; Sunela, Kaisa; Boman, Eva; Jukkola, Arja; Tiainen, Satu; Seppälä, Jan; Rönkä, Aino; Hakkarainen, Heikki; Kärnä, Aarno; Iivanainen, Sanna; Koivunen, Jussi; Auvinen, Päivi; Hernberg, Micaela; Kuusisto, Milla; Selander, Tuomas; Kuittinen, Outi (2023)
Jokimäki, Anna
Hietala, Henna
Lemma, Jasmiini
Karhapää, Hanna
Rintala, Anna
Kaikkonen, Jari Pekka
Sunela, Kaisa
Boman, Eva
Jukkola, Arja
Tiainen, Satu
Seppälä, Jan
Rönkä, Aino
Hakkarainen, Heikki
Kärnä, Aarno
Iivanainen, Sanna
Koivunen, Jussi
Auvinen, Päivi
Hernberg, Micaela
Kuusisto, Milla
Selander, Tuomas
Kuittinen, Outi
2023
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:tuni-202309158217
https://urn.fi/URN:NBN:fi:tuni-202309158217
Kuvaus
Peer reviewed
Tiivistelmä
Background: Immune-related adverse events (irAEs) are frequently encountered by patients during immune checkpoint inhibitor (ICI) treatment and are associated with better treatment outcomes. The sequencing of radiotherapy (RT) and ICIs is widely used in current clinical practice, but its effect on survival has remained unclear. Methods: In a real-world multicenter study including 521 patients who received ICI treatment for metastatic or locally advanced cancer, RT schedules and timing, irAEs, time to progression, overall survival, and treatment responses were retrospectively reviewed. Results: Patients who received previous RT and developed irAE (RT +/AE +) had the best overall response rate (ORR 44.0%). The ORR was 40.1% in the RT −/AE + group, 26.7% in the RT −/AE − group and 18.3% in the RT + /AE − group (p < 0.001). There was a significantly longer time to progression (TTP) in the RT + /AE + group compared to the RT −/AE − and RT + /AE − groups (log rank p = 0.001 and p < 0.001, respectively), but the trend toward longer TTP in the RT + /AE + group did not reach statistical significance in pairwise comparison to that in the RT −/AE + group. Preceding RT timing and intent had no statistically significant effect on TTP. In a multivariate model, ECOG = 0 and occurrence of irAEs remained independent positive prognostic factors for TTP (HR 0.737; 95% CI 0.582–0.935; p = 0.012, and HR 0.620; 95% CI 0.499–0.769; p < 0.001, respectively). Conclusions: Better ORR and a trend toward longer TTP were demonstrated for patients with RT preceding ICI treatment and development of irAEs, which suggests that RT may boost the therapeutic effect of immunotherapy in patients with metastatic cancers.
Kokoelmat
- TUNICRIS-julkaisut [19265]