2023 World Conference on Lung Cancer (Posters)-EP13.03. Small Cell Lung Cancer Immune Related Adverse Events, Survival Impacts

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A study conducted by Wake Forest University School of Medicine investigated the survival impact of immune-related adverse events (irAE) in patients with extensive stage small cell lung cancer (ES-SCLC). The study aimed to build upon existing evidence for non-small cell lung cancer (NSCLC) and determine if irAE also lead to improved survival in ES-SCLC patients. <br /><br />The retrospective analysis was conducted within a single institution, which may introduce subject bias. It should also be acknowledged that there are multiple mechanisms through which low-grade irAE can confer a survival benefit, and the actual underlying mechanism may be obscured. In addition, there is a risk of unmeasured confounding.<br /><br />The findings of the study showed that among SCLC patients treated with an immune checkpoint inhibitor (ICI), a low-grade irAE was associated with over a two-fold increase in overall survival compared to no irAE. Similarly, a high-grade irAE was associated with a nearly 50% increase in survival. These findings were similar to those observed in NSCLC patients and warrant further study to investigate potential mechanisms and predictive biomarkers.<br /><br />Low-grade adverse events (grade 1-2) were significantly associated with increased survival, independent of the severity of the disease. High-grade events had a non-significant increase in survival, likely confounded by competing risk. The study suggests that further research on the prediction and potential biomarkers of low-grade irAE could unlock the survival benefit for all SCLC patients.<br /><br />The study included a total cohort of 245 SCLC patients, with 56 (23%) experiencing irAEs, 24 (10%) of which were high-grade. The most common high-grade irAEs were diarrhea/colitis, pneumonitis, and inflammatory arthritis, while thyroiditis was the most common low-grade irAE.<br /><br />In conclusion, the study provides evidence that irAEs in ES-SCLC patients may be associated with improved survival, similar to findings in NSCLC patients. However, the retrospective nature of the analysis and the possibility of subject bias are limitations that should be considered. Further investigation is needed to understand the mechanisms and identify predictive biomarkers for the survival benefit observed.

Asset Subtitle

John Hunting

Meta Tag

Speaker John Hunting

Topic SCLC & Neuroendocrine Tumors: First Line Therapy

Keywords

immune-related adverse events

extensive stage small cell lung cancer

ES-SCLC

non-small cell lung cancer

irAE

overall survival

immune checkpoint inhibitor

retrospective analysis

low-grade irAE

high-grade irAE