Impact of the corticosteroid indication and administration route on overall survival and the tumor response after immune checkpoint inhibitor initiation Article Swipe
L Gaucher
,
Leslie Adda
,
Alice Séjourné
,
Camille Joachim
,
G. Chaby
,
Claire Poulet
,
Sophie Liabeuf
,
Valérie Gras‐Champel
,
Kamel Masmoudi
,
Aurélie Moreira
,
Youssef Bennis
,
Benjamin Batteux
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1177/1758835921996656
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1177/1758835921996656
Background: Based on their indications, systemic corticosteroids appear to negatively affect clinical outcomes in immune checkpoint inhibitor (ICI)-treated patients. There are few data on the influence of topical and inhaled corticosteroids on the ICIs’ effectiveness. Methods: In a single-center study, we retrospectively investigated the impact of systemic corticosteroids according to their indication [an immune-related adverse event (irAE) or another indication] on overall survival (OS) and the tumor response in all consecutive patients after initiation of ipilimumab, nivolumab or pembrolizumab over a 9-year period. The impacts of topical and inhaled corticosteroids were also examined. Results: Three hundred and seventy-two patients were included. The mean ± standard deviation age was 64.0 ± 12.1 years. The most frequently prescribed ICI was nivolumab (in 58.3% of the patients) and the most frequent indications were lung cancer (44.6%) and melanoma (29.6%). Systemic corticosteroid use for an irAE did not have a negative impact on OS [adjusted hazard ratio (HR) [95% confidence interval (CI)] 1.04 (0.56–1.95), p = 0.902] or the best overall tumor response [adjusted odds ratio (OR) (95% CI) 1.69 (0.52–6.56), p = 0.413], while systemic corticosteroid use for another indication was associated with shorter OS [adjusted HR (95% CI) 1.34 (1.05–2.03), p = 0.046] and a poor best overall tumor response [adjusted OR (95% CI) 2.04 (1.07–5.80), p = 0.039] with a cumulative dose cut-off of 3215 mg prednisolone equivalent (specificity 71.4%; sensitivity 65.3%) and a time cut-off of 132 days (specificity 71.4%; sensitivity 89.8%). The use of topical corticosteroids was associated with a longer OS; this was probably due to dermatological irAEs. Inhaled corticosteroid use did not influence OS. Conclusion: Systemic corticosteroid use for an irAE does not impact OS or the tumor response, whereas use for other indications (themselves often associated with a worse prognosis) does. Topical and inhaled steroids do not have a negative impact on OS.
Related Topics
Concepts
Medicine
Nivolumab
Hazard ratio
Corticosteroid
Pembrolizumab
Internal medicine
Ipilimumab
Adverse effect
Confidence interval
Odds ratio
Lung cancer
Gastroenterology
Cancer
Oncology
Immunotherapy
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1177/1758835921996656
- https://journals.sagepub.com/doi/pdf/10.1177/1758835921996656
- OA Status
- gold
- Cited By
- 31
- References
- 35
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3135254573
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3135254573Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1177/1758835921996656Digital Object Identifier
- Title
-
Impact of the corticosteroid indication and administration route on overall survival and the tumor response after immune checkpoint inhibitor initiationWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-01-01Full publication date if available
- Authors
-
L Gaucher, Leslie Adda, Alice Séjourné, Camille Joachim, G. Chaby, Claire Poulet, Sophie Liabeuf, Valérie Gras‐Champel, Kamel Masmoudi, Aurélie Moreira, Youssef Bennis, Benjamin BatteuxList of authors in order
- Landing page
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https://doi.org/10.1177/1758835921996656Publisher landing page
- PDF URL
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https://journals.sagepub.com/doi/pdf/10.1177/1758835921996656Direct link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
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https://journals.sagepub.com/doi/pdf/10.1177/1758835921996656Direct OA link when available
- Concepts
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Medicine, Nivolumab, Hazard ratio, Corticosteroid, Pembrolizumab, Internal medicine, Ipilimumab, Adverse effect, Confidence interval, Odds ratio, Lung cancer, Gastroenterology, Cancer, Oncology, ImmunotherapyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
31Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 8, 2024: 5, 2023: 8, 2022: 5, 2021: 5Per-year citation counts (last 5 years)
- References (count)
-
35Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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