Cancers (May 2024)

Endocrine Immune-Related Adverse Events Are Independent Predictors of Survival in Patients with Lung Cancer

  • Emmanouil Panagiotou,
  • Sofia Ntouraki,
  • Ioannis A. Vathiotis,
  • Maria Effrosyni Livanou,
  • Athanasios Trimis,
  • Georgios Evangelou,
  • Andriani Charpidou,
  • Konstantinos Syrigos,
  • Melpomeni Peppa

DOI
https://doi.org/10.3390/cancers16091764
Journal volume & issue
Vol. 16, no. 9
p. 1764

Abstract

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Lung cancer (LC) is a serious health problem worldwide. Survival outcomes have improved over time due to the widespread use of novel therapeutic agents, including immune checkpoint inhibitors (ICIs). Endocrine immune-related adverse events (e-irAEs) are common in LC patients treated with ICIs. We performed a retrospective study of patients with LC who received treatment with ICIs at a tertiary referral center between January 2014 and October 2023. In total, 983 LC patients were included in the study. E-irAEs presented at a median time of 4.1 months and included hypothyroidism (15.6%), hyperthyroidism (4.3%), adrenal insufficiency (0.4%), hypophysitis (0.4%), and diabetes mellitus (0.2%). These toxicities were not related to the duration of treatment or the type of ICIs. Most (97.6%) e-irAEs were mild (grade 1–2). Median overall survival (OS) was higher in LC patients who experienced e-irAEs (31.6 months) compared to those who did not (10.8 months). The difference remained statistically significant in the 3-month (HR: 0.42) and 6-month landmark analysis (HR: 0.51). The OS advantage was observed in both patients with NSCLC (HR: 0.36) and SCLC (HR: 0.27). Additional research is needed to validate the role of e-irAEs as an independent predictor of survival outcomes in patients with LC.

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