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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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Autores principales: Pinato, David J, Kaseb, Ahmed, Wang, Yinghong, Saeed, Anwaar, Szafron, David, Jun, Tomi, Dharmapuri, Sirish, Naqash, Abdul Rafeh, Muzaffar, Mahvish, Navaid, Musharraf, Khan, Uqba, Lee, ChiehJu, Bulumulle, Anushi, Yu, Bo, Paul, Sonal, Fessas, Petros, Nimkar, Neil, Bettinger, Dominik, Hildebrand, Hannah, Pressiani, Tiziana, Abugabal, Yehia I, Personeni, Nicola, Huang, Yi-Hsiang, Lozano-Kuehne, Jingky, Rimassa, Lorenza, Ang, Celina, Marron, Thomas U
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7542664/
https://www.ncbi.nlm.nih.gov/pubmed/33028690
http://dx.doi.org/10.1136/jitc-2020-000726
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author Pinato, David J
Kaseb, Ahmed
Wang, Yinghong
Saeed, Anwaar
Szafron, David
Jun, Tomi
Dharmapuri, Sirish
Naqash, Abdul Rafeh
Muzaffar, Mahvish
Navaid, Musharraf
Khan, Uqba
Lee, ChiehJu
Bulumulle, Anushi
Yu, Bo
Paul, Sonal
Fessas, Petros
Nimkar, Neil
Bettinger, Dominik
Hildebrand, Hannah
Pressiani, Tiziana
Abugabal, Yehia I
Personeni, Nicola
Huang, Yi-Hsiang
Lozano-Kuehne, Jingky
Rimassa, Lorenza
Ang, Celina
Marron, Thomas U
author_facet Pinato, David J
Kaseb, Ahmed
Wang, Yinghong
Saeed, Anwaar
Szafron, David
Jun, Tomi
Dharmapuri, Sirish
Naqash, Abdul Rafeh
Muzaffar, Mahvish
Navaid, Musharraf
Khan, Uqba
Lee, ChiehJu
Bulumulle, Anushi
Yu, Bo
Paul, Sonal
Fessas, Petros
Nimkar, Neil
Bettinger, Dominik
Hildebrand, Hannah
Pressiani, Tiziana
Abugabal, Yehia I
Personeni, Nicola
Huang, Yi-Hsiang
Lozano-Kuehne, Jingky
Rimassa, Lorenza
Ang, Celina
Marron, Thomas U
author_sort Pinato, David J
collection PubMed
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.
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spelling pubmed-75426642020-10-19 Impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapy Pinato, David J Kaseb, Ahmed Wang, Yinghong Saeed, Anwaar Szafron, David Jun, Tomi Dharmapuri, Sirish Naqash, Abdul Rafeh Muzaffar, Mahvish Navaid, Musharraf Khan, Uqba Lee, ChiehJu Bulumulle, Anushi Yu, Bo Paul, Sonal Fessas, Petros Nimkar, Neil Bettinger, Dominik Hildebrand, Hannah Pressiani, Tiziana Abugabal, Yehia I Personeni, Nicola Huang, Yi-Hsiang Lozano-Kuehne, Jingky Rimassa, Lorenza Ang, Celina Marron, Thomas U J Immunother Cancer Short Report 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. BMJ Publishing Group 2020-10-07 /pmc/articles/PMC7542664/ /pubmed/33028690 http://dx.doi.org/10.1136/jitc-2020-000726 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See https://creativecommons.org/licenses/by/4.0/.
spellingShingle Short Report
Pinato, David J
Kaseb, Ahmed
Wang, Yinghong
Saeed, Anwaar
Szafron, David
Jun, Tomi
Dharmapuri, Sirish
Naqash, Abdul Rafeh
Muzaffar, Mahvish
Navaid, Musharraf
Khan, Uqba
Lee, ChiehJu
Bulumulle, Anushi
Yu, Bo
Paul, Sonal
Fessas, Petros
Nimkar, Neil
Bettinger, Dominik
Hildebrand, Hannah
Pressiani, Tiziana
Abugabal, Yehia I
Personeni, Nicola
Huang, Yi-Hsiang
Lozano-Kuehne, Jingky
Rimassa, Lorenza
Ang, Celina
Marron, Thomas U
Impact of corticosteroid therapy on the outcomes of hepatocellular carcinoma treated with immune checkpoint inhibitor therapy
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
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7542664/
https://www.ncbi.nlm.nih.gov/pubmed/33028690
http://dx.doi.org/10.1136/jitc-2020-000726
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