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Association of immune-related adverse events (irAEs) with improved response, progression-free survival, and overall survival for patients with metastatic head and neck cancer receiving anti-PD-1 therapy.
Abstract
6014 Background: Anti-programmed death receptor-1 (PD-1) therapies are approved for recurrent/metastatic head and neck (H&N) cancer progressing on or after platinum-based chemotherapy, and immune competence may modulate anti-tumor response. We hypothesized that developing immune-related adverse events (irAEs) while receiving anti-PD-1 therapy for metastatic H&N cancer would be associated with improved outcomes. Methods: 114 patients with metastatic H&N cancer unselected for PD-ligand 1 (PD-L1) status received anti-PD-1 therapy. Adverse events (AEs) were prospectively graded using CTCAE v4.0. irAEs were any possibly immune-mediated AE regardless of attribution. Univariate and multivariate logistic regression analyzed the relationship between irAEs and overall response rate (ORR) measured by RECIST v1.1. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier methods and Cox proportional hazard regression. Results: Median follow-up was 8.6 months, and follow-up did not significantly differ between irAE+/- groups (p = 0.72). Baseline characteristics including known PD-L1+ (53.1% irAE+ vs. 49.2% irAE-, p = 0.76) were comparable. 59 irAEs occurred in 49 patients. irAEs were classified as dermatologic (n = 20), pulmonary (n = 1), GI (n = 1), endocrine (n = 14), musculoskeletal (n = 15), ophthalmologic (n = 2), or hepatic (n = 6). 5 patients (10.2%) experienced grade ≥3 irAE. ORR was higher for the irAE+ (30.6%) compared to the irAE- (12.3%) group (p = 0.02). Median PFS was 6.9 months for irAE+ and 2.1 months for irAE- patients (p = 0.0004), while median OS was 12.5 months and 6.8 months (p = 0.007), respectively. On multivariate analyses, irAE+ was independently associated with improved ORR (p = 0.03), PFS (p = 0.009), and OS (p = 0.003). Conclusions: Developing irAEs while receiving anti-PD-1 therapy is associated with superior ORR, PFS, and, in particular, OS in this cohort of H&N cancer patients unselected for PD-L1 status. The ability to develop irAEs may be an indicator of immune competence and further investigation of biomarkers of immune competence is warranted.
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In that analysis, patients with IRAEs had improved ORR compared to those without (30.6% vs 12.3%, p = .02).
“Patients with IRAEs had improved ORR (30.6% vs 12.3%, p = .02)”
From Immune-related adverse events and anti-tumor efficacy of immune checkpoint inhibitors (2019) · cites this paper as [44]
In an analysis of 114 patients with metastatic HNSCC treated with anti-PD-1 antibodies, 43% experienced IRAEs.
“Of the patients, 43% experienced IRAEs with the most common sites being dermatologic (33.9%), musculoskeletal (25.4%) and endocrine (23.7%).”
From Immune-related adverse events and anti-tumor efficacy of immune checkpoint inhibitors (2019) · cites this paper as [44]
In that analysis, patients with IRAEs had improved OS compared to those without (12.5 vs 6.8 months, p = .0007).
“OS (12.5 vs 6.8 months, p = .0007)”
From Immune-related adverse events and anti-tumor efficacy of immune checkpoint inhibitors (2019) · cites this paper as [44]
In that analysis, patients with IRAEs had improved PFS compared to those without (6.9 vs 2.1 months, p = .0004).
“PFS (6.9 vs 2.1 months, p = .0004)”
From Immune-related adverse events and anti-tumor efficacy of immune checkpoint inhibitors (2019) · cites this paper as [44]
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Metadata
- Authors
- Foster, C. C., Kochanny, S., Khattri, A., Acharya, R., Dekker, A., Tan, Y.-H. C., Klema, E., Brisson, R. J., Saloura, V., Pearson, A. T., Vokes, E. E., Leidner, R. S., Mehanna, H. M., & Seiwert, T. Y.
- Affiliations
- University of Chicago (US)
- Oakland University (US)
- Earle A. Chiles Research Institute at Robert W. Franz Cancer Center, Providence Cancer Institute, Portland, OR;
- University of Birmingham (GB)
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2018-05-20
- Volume
- 36
- Issue
- 15_suppl
- Pages
- 6014-6014
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2889810844
- Cited by
- 28
- References
- 0
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 8 · 2019: 7 · 2018: 3
- Type
- conference abstract
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Oncology (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Keywords
- immune-related adverse events, anti-PD-1 therapy, metastatic head and neck cancer, immune checkpoint inhibitors, PD-L1 expression, overall response rate, progression-free survival, overall survival, immune activation, immune-related pneumonitis, immune-related dermatitis, immune-related endocrine adverse events
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