Journal Article Epublish
PubMed: 40227797 DOI: 10.3390/cancers17071198
Real-World Evaluation of Immune-Related Endocrinopathies in Metastatic NSCLC Patients Treated with ICIs in Romania.
Cancers (Basel) 17(7)
Authors: Simona Coniac, Mariana Cristina Costache-Outas, Ionuţ-Lucian Antone-Iordache, Ana-Maria Barbu, Victor Teodor Bardan, Andreea Zamfir, Andreea-Iuliana Ionescu, Corin Badiu
Affiliations
- Department of Medical Oncology, Hospice Hope Bucharest, 023642 Bucharest, Romania.
- Department of Endocrinology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
- Department of Endocrinology, Coltea Clinical Hospital, 030167 Bucharest, Romania.
- Department of Radiotherapy, Coltea Clinical Hospital, 030167 Bucharest, Romania.
- Department of Medical Oncology, Colțea Clinical Hospital, 030167 Bucharest, Romania.
- C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, Romania.
Abstract
(1) Background: Exploring real-world data (RWD) regarding immune-related adverse events (irAEs) is crucial to better understand the efficacy and safety of immunotherapy in cancer patient populations excluded from clinical trials. An analysis was conducted to evaluate the presumptive predictive causality between endocrine irAEs and the efficacy of immune check-point inhibitors (ICIs) in metastatic non-small-cell lung cancer (mNSCLC) patients treated in daily practice in Romania. (2) Methods: This was a retrospective cohort study of mNSCLC patients treated with ICIs in a tertiary level hospital in Romania for a period of almost seven years, from November 2017 till July 2024. Endocrine irAEs were well defined as any occurring autoimmune endocrinopathy during ICIs and related to immunotherapy. The hospital endocrinologist (M.C.C.O) diagnosed, treated, and followed these endocrine irAEs in a multidisciplinary approach. We investigated multiple medical variables to assess their impact on ICI effectiveness. Descriptive and statistical analyses were performed. (3) Results: Of 487 cancer patients treated with ICIs, we identified 215 mNSCLC patients who were evaluated for endocrine irAEs and co-medications during ICI therapy. Forty-seven (21.8%) patients experienced endocrine irAEs, thyroiditis being the most frequent and prevalent autoimmune endocrinopathy in 60% of cases. Endocrine irAEs were statistically significant, correlated with ICI efficacy ( = 0.002) for survival analysis. Steroids and proton-pump inhibitors used as co-medication during ICIs had a negative impact on response to therapy. (4) Conclusions: Endocrine irAEs might be considered predictive biomarkers for successful immunotherapy in mNSCLC patients. Co-medication during ICIs had a major influence on the effectiveness of these cutting-edge therapies. RWD plays an important role for oncology daily practice whenever clinical trial evidence is not available to guide decision.
MeSH
Neoplasms, Carcinoma, Non-Small-Cell Lung, Immunotherapy, Therapeutics