Immune-mediated reactions predict survival in NSCLC patients treated with nivolumab

Several patients with nonsmall cell lung cancer (NSCLC) treated with nivolumab report developing immune-related adverse events (irAEs), primarily affecting the skin, lungs, and gastrointestinal system, according to a study.

Seventy-five NSCLC patients who received nivolumab between February 2015 to May 2020 were included in this retrospective, observational, and longitudinal study. The authors assessed the safety and effectiveness of the study drug by recording irAEs and their severity and calculating overall (OS) and progression-free survival (PFS), respectively.

Of the patients, 32 (43 percent) reported irAEs, most of which involved the skin (36 percent). Other irAEs included pneumonitis (20 percent), gastrointestinal reactions (12 percent), endocrine (12 percent), and hepatitis (12 percent). Majority (92 percent) of these events were moderate in severity.

Survival was better in patients who experienced irAEs than in those without (median PFS: 9.49 vs 1.99 months; p<0.0001; median OS: 17.44 vs 7.67 months; p=0.0001).

Specifically, PFS was 20.53 months for patients who developed ≥2 irAEs, 5.35 months for one event, and 1.99 months for none (p<0.0001), while the corresponding median OS was 23.41, 15.80, and 7.67 months (p=0.0002).

“We confirm that the development of irAEs in patients with NSCLC treated with nivolumab is a strong predictor of treatment effectiveness in both PFS and OS, with statistically significant results,” the authors said. “On those patients who experience two or more irAEs the greatest benefit has been observed.”