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

• Published in: Cancers Vol. 16; no. 9; p. 1764
• Main Authors: Panagiotou, Emmanouil, Ntouraki, Sofia, Vathiotis, Ioannis A, Livanou, Maria Effrosyni, Trimis, Athanasios, Evangelou, Georgios, Charpidou, Andriani, Syrigos, Konstantinos, Peppa, Melpomeni
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-05-2024
• Subjects: Cancer; Cancer patients; Cancer therapies; Care and treatment; Chemotherapy; Cytotoxicity; Development and progression; Diabetes; Diabetes mellitus; Disease; Hyperthyroidism; Hypothesis testing; Hypothyroidism; Immune checkpoint inhibitors; Immune system; Immunotherapy; Lung cancer; Lung cancer, Non-small cell; Medical prognosis; Metastasis; Multivariate analysis; Non-small cell lung carcinoma; Oncology, Experimental; Patient outcomes; Patients; Public health; Regression analysis; Statistical analysis; Survival; Thyroid gland; Thyroid hormones; Greece; endocrine toxicity; small-cell lung cancer; immune-related adverse events; thyroid disorders; PD-L1; CTLA-4; diabetes mellitus; immune checkpoint inhibitors; PD-1; pituitary disorders; non-small-cell lung cancer
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers16091764

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.