Jokimäki, A., Hietala, H., Lemma, J. et al. Previous radiotherapy improves treatment responses and causes a trend toward longer time to progression among patients with immune checkpoint inhibitor-related adverse events. Cancer Immunol Immunother 72, 3337–3347 (2023). https://doi.org/10.1007/s00262-023-03494-4
Previous radiotherapy improves treatment responses and causes a trend toward longer time to progression among patients with immune checkpoint inhibitor-related adverse events
|Author:||Jokimäki, Anna1,2,3; Hietala, Henna1; Lemma, Jasmiini4;|
1Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
2Faculty of Health Sciences, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
3Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
4Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
5University of Helsinki, Helsinki, Finland
6Faculty of Medicine and Health Technology, Tampere Cancer Center, Tampere University, Tampere, Finland
7Department of Oncology, Tampere University Hospital, Tampere, Finland
8Center of Oncology, Kuopio University Hospital, Kuopio, Finland
9Department of Oncology, Hospital of Central Finland Nova, Jyvaskyla, Finland
10Department of Hematology, Oulu University Hospital, Oulu, Finland
11Science Service Center, Kuopio University Hospital, Kuopio, Finland
|Online Access:||PDF Full Text (PDF, 1.3 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe20231109143682
|Publish Date:|| 2023-11-09
Background: Immune-related adverse events (irAEs) are frequently encountered by patients during immune checkpoint inhibitor (ICI) treatment and are associated with better treatment outcomes. The sequencing of radiotherapy (RT) and ICIs is widely used in current clinical practice, but its effect on survival has remained unclear.
Methods: In a real-world multicenter study including 521 patients who received ICI treatment for metastatic or locally advanced cancer, RT schedules and timing, irAEs, time to progression, overall survival, and treatment responses were retrospectively reviewed.
Results: Patients who received previous RT and developed irAE (RT +/AE +) had the best overall response rate (ORR 44.0%). The ORR was 40.1% in the RT −/AE + group, 26.7% in the RT −/AE − group and 18.3% in the RT + /AE − group (p < 0.001). There was a significantly longer time to progression (TTP) in the RT + /AE + group compared to the RT −/AE − and RT + /AE − groups (log rank p = 0.001 and p < 0.001, respectively), but the trend toward longer TTP in the RT + /AE + group did not reach statistical significance in pairwise comparison to that in the RT −/AE + group. Preceding RT timing and intent had no statistically significant effect on TTP. In a multivariate model, ECOG = 0 and occurrence of irAEs remained independent positive prognostic factors for TTP (HR 0.737; 95% CI 0.582–0.935; p = 0.012, and HR 0.620; 95% CI 0.499–0.769; p < 0.001, respectively).
Conclusions: Better ORR and a trend toward longer TTP were demonstrated for patients with RT preceding ICI treatment and development of irAEs, which suggests that RT may boost the therapeutic effect of immunotherapy in patients with metastatic cancers.
Cancer immunology, immunotherapy
|Pages:||3337 - 3347|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3126 Surgery, anesthesiology, intensive care, radiology
Open access funding provided by University of Eastern Finland (UEF) including Kuopio University Hospital. This work was supported by a Grant from the Northern Finland Cancer Society (Pohjois-Suomen syöpäyhdistys r.y.) (A.J.) and Terttu Foundation (A.J.). S.I.’s institution has received research funding from AstraZeneca and Roche. The funding bodies did not contribute to study design, data collection, data analysis or writing this article.
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