Long-term real-world outcomes in patients with metastatic non-small cell lung cancer and immune-mediated adverse events

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Abstract

Background. The negative side of immunotherapy with immune checkpoint inhibitors for patients with metastatic non-small cell lung cancer (NSCLC) is the development of immune-mediated adverse events (imAE).

Aim. To determine the association between imAE and overall survival (OS), progression-free survival (PFS) in patients with metastatic NSCLC receiving immunotherapy.

Materials and methods. The study included data on treatment of patients with metastatic NSCLC who received immunotherapy at the N. N. Blokhin National Medical Research Center of Oncology between 2015 and 2023. The patients were divided into two groups: those who developed any grade imAE and those who did not. The primary endpoints of the study were PFS and OS. Landmark analysis was performed to avoid immortal time bias.

Results. The study included 461 patients. Any grade imAE occurred in 138 patients, while 323 patients did not experience imAE. The median follow-up time was 60.7 months. For the patients with and without imAE in a 16-month landmark analysis, median OS was 70.0 months (95 % confidence interval (CI) 39.93–100.06) and 45.4 months (95 % CI 38.78–52.01) (p = 0.048), respectively. And in a 6.5-month landmark analysis, median PFS was 16.7 months (95 % CI 1.25–32.14) and 20.6 months (95 % CI 14.98–26.21) (p = 0.942) for patients with and without imAE, respectively.

Conclusion. Immune-mediated adverse events during immunotherapy in patients with metastatic NSCLC are associated with better overall survival when a landmark analysis was applied.

About the authors

D. I. Yudin

N. N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: yudinden@mail.ru
ORCID iD: 0000-0002-0620-2696
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

K. K. Laktionov

N. N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: yudinden@mail.ru
ORCID iD: 0000-0003-4469-502X
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

I. A. Djanyan

N. N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: yudinden@mail.ru
ORCID iD: 0000-0002-6323-511X
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

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