PMID- 33101774
OWN - NLM
STAT- MEDLINE
DCOM- 20210728
LR  - 20210728
IS  - 2162-4011 (Print)
IS  - 2162-402X (Electronic)
IS  - 2162-4011 (Linking)
VI  - 9
IP  - 1
DP  - 2020 Oct 5
TI  - Association of baseline systemic corticosteroid use with overall survival and 
      time to next treatment in patients receiving immune checkpoint inhibitor therapy 
      in real-world US oncology practice for advanced non-small cell lung cancer, 
      melanoma, or urothelial carcinoma.
PG  - 1824645
LID - 10.1080/2162402X.2020.1824645 [doi]
LID - 1824645
AB  - Immune checkpoint inhibitors (CPIs) have expanded treatment options for patients 
      with solid tumors. Systemic corticosteroids (CSs) have an indispensable role in 
      cancer care, but CS-related immunosuppression may counteract the CPI-driven 
      antitumor immune response. This retrospective study investigated the association 
      between baseline CS use (bCS; </=14 days before, </=30 days after CPI initiation) and 
      clinical outcomes in patients with advanced non-small cell lung cancer (aNSCLC), 
      melanoma (aMel), or urothelial carcinoma (aUC). We analyzed data from the 
      Flatiron Health electronic health record-derived de-identified database for 
      adults diagnosed with aNSCLC, aMel, or aUC between January 2011 and June 2017 who 
      received >/=1 CPI monotherapy in any treatment line. Associations of bCS use with 
      overall survival (OS) and time to next treatment (TTNT) were estimated using 
      multivariable Cox proportional hazards models adjusting for demographic and 
      clinical characteristics (i.e., ECOG performance status, site of metastases). In 
      total, 2,213 patients were diagnosed with aNSCLC (n = 862), aMel (n = 742), or 
      aUC (n = 609) and received >/=1 CPI administration. Most patients (67%-95%) 
      received CSs, many during the baseline period (19%-30%). Patients with bCS use 
      had shorter median OS than those with no bCS use for aNSCLC (6.6 vs 10.6 months; 
      P= .00018), aMel (16.4 vs 21.5; P= .095), and aUC (4.1 vs 7.7; P= .0012). bCS use 
      was associated with shorter OS (not significant for aMel) and TTNT in adjusted 
      multivariable analyses, and clinical outcomes were not explained by prior CS use 
      or other measured confounders. These findings suggest a potential association 
      between bCS use and decreased CPI effectiveness, warranting further 
      investigation.
CI  - (c) 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.
FAU - Drakaki, Alexandra
AU  - Drakaki A
AD  - Division of Hematology/Oncology, David Geffen School of Medicine, University of 
      California, Los Angeles, CA, USA.
FAU - Dhillon, Preet K
AU  - Dhillon PK
AD  - Personalized Healthcare, Product Developmen, Genentech, Inc, South San Francisco, 
      CA, USA.
FAU - Wakelee, Heather
AU  - Wakelee H
AD  - Thoracic Oncology, Stanford Medical School, Stanford, CA, USA.
FAU - Chui, Stephen Y
AU  - Chui SY
AD  - Product Development Oncology, Genentech, Inc, South San Francisco, CA, USA.
FAU - Shim, Jinjoo
AU  - Shim J
AD  - Personalized Healthcare, Product Development, F. Hoffmann-La Roche Ltd, Basel, 
      Switzerland.
FAU - Kent, Matthew
AU  - Kent M
AD  - Real World Evidence Solutions, Genesis Research, Hoboken, NJ, USA.
FAU - Degaonkar, Viraj
AU  - Degaonkar V
AD  - Product Development Oncology, Genentech, Inc, South San Francisco, CA, USA.
FAU - Hoang, Tien
AU  - Hoang T
AD  - Product Development Oncology, Genentech, Inc, South San Francisco, CA, USA.
FAU - McNally, Virginia
AU  - McNally V
AD  - Clinical Development, Roche Products Ltd, Welwyn Garden City, UK.
FAU - Luhn, Patricia
AU  - Luhn P
AD  - Personalized Healthcare, Product Developmen, Genentech, Inc, South San Francisco, 
      CA, USA.
FAU - Gutzmer, Ralf
AU  - Gutzmer R
AD  - Clinic for Dermatology, Allergology und Venerology, Hannover Medical School, 
      Hannover, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20201005
PL  - United States
TA  - Oncoimmunology
JT  - Oncoimmunology
JID - 101570526
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Immune Checkpoint Inhibitors)
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Adult
MH  - *Carcinoma, Non-Small-Cell Lung/drug therapy
MH  - *Carcinoma, Transitional Cell
MH  - Humans
MH  - Immune Checkpoint Inhibitors
MH  - *Lung Neoplasms/drug therapy
MH  - *Melanoma
MH  - Retrospective Studies
MH  - *Urinary Bladder Neoplasms
PMC - PMC7553559
OTO - NOTNLM
OT  - Checkpoint inhibitors
OT  - corticosteroids
OT  - melanoma
OT  - non-small cell lung cancer
OT  - urothelial cancer
EDAT- 2020/10/27 06:00
MHDA- 2020/10/27 06:01
PMCR- 2020/10/05
CRDT- 2020/10/26 05:24
PHST- 2020/10/26 05:24 [entrez]
PHST- 2020/10/27 06:00 [pubmed]
PHST- 2020/10/27 06:01 [medline]
PHST- 2020/10/05 00:00 [pmc-release]
AID - 1824645 [pii]
AID - 10.1080/2162402X.2020.1824645 [doi]
PST - epublish
SO  - Oncoimmunology. 2020 Oct 5;9(1):1824645. doi: 10.1080/2162402X.2020.1824645.