Effect of Systemic Corticosteroid Therapy on the Efficacy and Safety of Nivolumab in the Treatment of Non-Small-Cell Lung Cancer

• Published in: Cancer control Vol. 28; p. 1073274820985790
• Main Authors: Umehara, Kengo, Yama, Kaori, Goto, Keisuke, Wakamoto, Azusa, Hatsuyama, Tae, Honjo, Osamu, Saikai, Toyohiro, Fujita, Akihisa, Sato, Hideki
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2021; Sage Publications Ltd; SAGE Publishing
• Subjects: Adrenal Cortex Hormones - pharmacology; Adrenal Cortex Hormones - therapeutic use; Adverse events; Aged; Antineoplastic Agents, Immunological - pharmacology; Antineoplastic Agents, Immunological - therapeutic use; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - pathology; Clinical trials; Corticosteroids; Disease control; Female; Humans; Immunotherapy; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Male; Medical prognosis; Middle Aged; Monoclonal antibodies; Nivolumab - pharmacology; Nivolumab - therapeutic use; Non-small cell lung carcinoma; Original; Patients; Retrospective Studies; Steroids; Targeted cancer therapy; nivolumab; corticosteroid; non-small-cell lung cancer
• ISSN: 1073-2748; 1526-2359; 1073-2748
• DOI: 10.1177/1073274820985790

Introduction: Corticosteroids are used to treat immune-related adverse events (irAEs) associated with nivolumab. However, patients with non-small-cell lung cancer who are administered corticosteroids before the initiation of nivolumab treatment are commonly excluded from clinical trials. The appropriate timing for corticosteroid administration in relation to nivolumab treatment, effects of corticosteroids on the efficacy of nivolumab, and resulting adverse events are not clearly understood. In this study, the effects of differences in the timing of corticosteroid administration on nivolumab efficacy and the resulting adverse events were examined. Methods: A retrospective study was conducted with 109 patients who were treated with nivolumab at Sapporo Minami-Sanjo Hospital between December 2015 and March 2018. Results: Of the 109 patients treated with nivolumab, 12 patients were administered corticosteroids before the first cycle of nivolumab (pre-CS), and 33 patients were administered corticosteroids after the first cycle of nivolumab (post-CS). These 2 groups were compared with the control group comprising 64 patients who were not administered corticosteroids (non-CS). The objective response rate in the post-CS group was significantly higher than that in the non-CS group, and the disease control rate in the pre-CS group was significantly lower than that in the non-CS group. The overall survival time and progression-free survival time in the pre-CS group were significantly shorter than those observed in the non-CS group; however, these did not differ from those in the post-CS group. Conclusions: These results suggest that corticosteroids administered to patients with non-small-cell lung cancer after initiation of nivolumab treatment did not affect the disease prognosis. Thus, corticosteroids can be administered immediately for rapid treatment of irAEs.