Impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapy
The impact of corticosteroid therapy (CT) on efficacy of immune checkpoint inhibitors (ICI) is undefined in hepatocellular carcinoma (HCC). We evaluated whether CT administered at baseline (bCT) or concurrently with ICI (cCT) influences overall (OS), progression-free survival (PFS) and overall respo...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-10-01
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| Series: | Journal for ImmunoTherapy of Cancer |
| Online Access: | https://jitc.bmj.com/content/8/2/e000726.full |
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| author | Dominik Bettinger Bo Yu David Szafron Yinghong Wang Abdul Rafeh Naqash Mahvish Muzaffar Uqba Khan Yi-Hsiang Huang David J Pinato Ahmed Kaseb Anwaar Saeed Tomi Jun Sirish Dharmapuri Musharraf Navaid ChiehJu Lee Anushi Bulumulle Sonal Paul Petros Fessas Neil Nimkar Hannah Hildebrand Tiziana Pressiani Yehia I Abugabal Nicola Personeni Jingky Lozano-Kuehne Lorenza Rimassa Celina Ang Thomas U Marron |
| author_facet | Dominik Bettinger Bo Yu David Szafron Yinghong Wang Abdul Rafeh Naqash Mahvish Muzaffar Uqba Khan Yi-Hsiang Huang David J Pinato Ahmed Kaseb Anwaar Saeed Tomi Jun Sirish Dharmapuri Musharraf Navaid ChiehJu Lee Anushi Bulumulle Sonal Paul Petros Fessas Neil Nimkar Hannah Hildebrand Tiziana Pressiani Yehia I Abugabal Nicola Personeni Jingky Lozano-Kuehne Lorenza Rimassa Celina Ang Thomas U Marron |
| author_sort | Dominik Bettinger |
| collection | DOAJ |
| description | The impact of corticosteroid therapy (CT) on efficacy of immune checkpoint inhibitors (ICI) is undefined in hepatocellular carcinoma (HCC). We evaluated whether CT administered at baseline (bCT) or concurrently with ICI (cCT) influences overall (OS), progression-free survival (PFS) and overall response rates (ORR) in 341 patients collected across 3 continents. Of 304 eligible patients, 78 (26%) received >10 mg prednisone equivalent daily either as bCT (n=14, 5%) or cCT (n=64, 21%). Indications for CT included procedure/prophylaxis (n=37, 47%), management of immune-related adverse event (n=27, 35%), cancer-related symptoms (n=8, 10%) or comorbidities (n=6, 8%). Neither overall CT, bCT nor cCT predicted for worse OS, PFS nor ORR in univariable and multivariable analyses (p>0.05). CT for cancer-related indications predicted for shorter PFS (p<0.001) and was associated with refractoriness to ICI (75% vs 33%, p=0.05) compared with cancer-unrelated indications. This is the first study to demonstrate that neither bCT nor cCT influence response and OS following ICI in HCC. Worse outcomes in CT recipients for cancer-related indications appear driven by the poor prognosis associated with symptomatic HCC. |
| format | Article |
| id | doaj-art-fd5dfa2eba3b4f96a6696a68a05a1a49 |
| institution | OA Journals |
| issn | 2051-1426 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Journal for ImmunoTherapy of Cancer |
| spelling | doaj-art-fd5dfa2eba3b4f96a6696a68a05a1a492025-08-20T02:13:19ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262020-10-018210.1136/jitc-2020-000726Impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapyDominik Bettinger0Bo Yu1David Szafron2Yinghong Wang3Abdul Rafeh Naqash4Mahvish Muzaffar5Uqba Khan6Yi-Hsiang Huang7David J Pinato8Ahmed Kaseb9Anwaar Saeed10Tomi Jun11Sirish Dharmapuri12Musharraf Navaid13ChiehJu Lee14Anushi Bulumulle15Sonal Paul16Petros Fessas17Neil Nimkar18Hannah Hildebrand19Tiziana Pressiani20Yehia I Abugabal21Nicola Personeni22Jingky Lozano-Kuehne23Lorenza Rimassa24Celina Ang25Thomas U Marron2611 Department of Medicine II, Faculty of Medicine, Medical Center University of Freiburg, Freiburg, GermanyDepartment of Medicine, New York City Health and Hospitals/ Lincoln, New York City, New York, USA2 Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA3 Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USAMedical Oncology/TSET Phase 1 Program, The University of Oklahoma Stephenson Cancer Center, Oklahoma City, Oklahoma, USA7 Division of Hematology/Oncology, East Carolina University, Greenville, North Carolina, United States8 Division of Hematology and Oncology, Weill Cornell Medicine/New York Presbyterian Hospital, Ithaca, New York, USA9 Division of Gastroenterology and Hepatology, Department of Medicine at Taipei Veterans General Hospital and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan16 Department of Surgery & Cancer, Imperial College London, London, UK2 Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA4 Division of Medical Oncology, Kansas University Cancer Center, Kansas City, Kansas, USA5 Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Mount Sinai Hospital School of Medicine, New York, New York, USA5 Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Mount Sinai Hospital School of Medicine, New York, New York, USA7 Division of Hematology/Oncology, East Carolina University, Greenville, North Carolina, USA9 Division of Gastroenterology and Hepatology, Department of Medicine at Taipei Veterans General Hospital and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan10 Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA10 Department of Medicine, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States11 Surgery and Cancer, Imperial College London, London, UK8 Division of Hematology and Oncology, Weill Cornell Medicine/New York Presbyterian Hospital, Ithaca, New York, USA4 Division of Medical Oncology, Kansas University Cancer Center, Kansas City, Kansas, USA13 Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, IRCCS, Via Manzoni 56, Rozzano, Milan, Italy2 Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA13 Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, IRCCS, Via Manzoni 56, Rozzano, Milan, ItalyPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK13 Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, IRCCS, Via Manzoni 56, 20089 Rozzano, Milan, Italy1Icahn School of Medicine at Mount Sinai, New York, NY, USADepartment of Medicine, Division of Hematology Oncology, Mount Sinai School of Medicine, New York, New York, USAThe impact of corticosteroid therapy (CT) on efficacy of immune checkpoint inhibitors (ICI) is undefined in hepatocellular carcinoma (HCC). We evaluated whether CT administered at baseline (bCT) or concurrently with ICI (cCT) influences overall (OS), progression-free survival (PFS) and overall response rates (ORR) in 341 patients collected across 3 continents. Of 304 eligible patients, 78 (26%) received >10 mg prednisone equivalent daily either as bCT (n=14, 5%) or cCT (n=64, 21%). Indications for CT included procedure/prophylaxis (n=37, 47%), management of immune-related adverse event (n=27, 35%), cancer-related symptoms (n=8, 10%) or comorbidities (n=6, 8%). Neither overall CT, bCT nor cCT predicted for worse OS, PFS nor ORR in univariable and multivariable analyses (p>0.05). CT for cancer-related indications predicted for shorter PFS (p<0.001) and was associated with refractoriness to ICI (75% vs 33%, p=0.05) compared with cancer-unrelated indications. This is the first study to demonstrate that neither bCT nor cCT influence response and OS following ICI in HCC. Worse outcomes in CT recipients for cancer-related indications appear driven by the poor prognosis associated with symptomatic HCC.https://jitc.bmj.com/content/8/2/e000726.full |
| spellingShingle | Dominik Bettinger Bo Yu David Szafron Yinghong Wang Abdul Rafeh Naqash Mahvish Muzaffar Uqba Khan Yi-Hsiang Huang David J Pinato Ahmed Kaseb Anwaar Saeed Tomi Jun Sirish Dharmapuri Musharraf Navaid ChiehJu Lee Anushi Bulumulle Sonal Paul Petros Fessas Neil Nimkar Hannah Hildebrand Tiziana Pressiani Yehia I Abugabal Nicola Personeni Jingky Lozano-Kuehne Lorenza Rimassa Celina Ang Thomas U Marron Impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapy Journal for ImmunoTherapy of Cancer |
| title | Impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapy |
| title_full | Impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapy |
| title_fullStr | Impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapy |
| title_full_unstemmed | Impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapy |
| title_short | Impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapy |
| title_sort | impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapy |
| url | https://jitc.bmj.com/content/8/2/e000726.full |
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