Could immune-related adverse events predict the effectiveness of immune checkpoint inhibitors in patients with lung cancer?

This study investigated whether immune-related side effects (irSEs) could predict the effectiveness of immune checkpoint inhibitors (ICIs) in patients with lung cancer. The data showed that the occurrence of skin, hormone, and gastrointestinal irSEs could predict the effectiveness of immunotherapy in these patients.

Immunotherapy uses the body’s own immune system to fight cancer. Immune checkpoint inhibitors (ICIs) are a type of immunotherapy used to treat a wide variety of cancers. Tumor cells try to avoid death by switching off our immune system. ICIs work by blocking the off switch of the immune system. Pembrolizumab (Keytruda) and nivolumab (Opdivo) are examples of ICIs that work by blocking PD-1, an important protein in the immune system. This leads to the immune system attacking tumor cells and killing them.

The most common side effects associated with immunotherapy are known as immune-related side effects (irSEs). These events often include skin rashes or inflammation in areas such as the lungs, intestines, or thyroid. Whether irSEs could predict the effectiveness of immune checkpoint inhibitors (ICIs) in patients with lung cancer is still not clear.

This study analyzed 34 studies that involved 8115 patients with lung cancer undergoing ICI therapy. The occurrence of irSEs was compared to the response to treatment and survival.

The patients who experienced irSEs were 2.43 times more likely to respond better to ICIs immunotherapy than those who did not have irSEs.

The occurrence of irSEs also was associated with improved overall survival (OS) and survival without cancer worsening. The OS was significantly longer for patients who developed skin (by 47%), hormonal (by 45%), and gastrointestinal (by 42%) irSEs than in those who did not.

This study concluded that the occurrence of skin, hormonal, and gastrointestinal irSEs could be a predictor of the effectiveness of immunotherapy in patients with lung cancer treated with ICIs.

This study looked back in time at medical records. The data on the association between low-grade irSEs and patient outcomes was missing.