Clin Cancer Res: Early use of high-dose hormones to manage irAE is associated with poor prognosis of anti-PD-1 monotherapy for advanced melanoma

Programmed cell death receptor-1 (PD-1) inhibitors are the first-line treatment for advanced melanoma
.

Severe immune- related adverse reactions (ieAE) usually require glucocorticoid (GCC) immunosuppressive therapy

immunity

This is a multicenter retrospective analysis that included patients treated with anti-PD-1 monoclonal therapy from 2009 to 2019, and collected detailed GCC use data from five independent cohorts
.

The median follow-up time was 206 weeks

PFS of two groups of patients in the MGH cohort and validation cohort

PFS of two groups of patients in the MGH cohort and validation cohort

Of the 947 patients in the total cohort, 509 (54%) patients had an irAE
.

In the MGH cohort (irAE[+]n=90), early-onset irAE (anti-PD-1 treatment ) with high-dose GCC (≥60 mg, prednisone) was used compared with irAE without early use of high-dose GCC Within the first 8 weeks after irAE ) was independently associated with poorer PFS and OS after irAE (PFS after irAE: HR 5.

Compared with irAEs that did not use high-dose GCC early, compared with irAEs that did not use high-dose GCC early, the early-onset irAEs of early-onset irAEs that used high-dose GCC had higher PFS and OS after irAE.
Poor independent correlation is associated with poor PFS and OS after irAE

OS of two groups of patients in MGH cohort and validation cohort

OS of two groups of patients in MGH cohort and validation cohort

The above research results were confirmed in the combined validation cohort (irAE[+]n=419, PFS after irAE: HR1.
69, 95%CI 1.
04-2.
76, p=0.
04; OS: HR 1.
97, 95%CI 1.
15-3.
39 , p=0.
01)
.

In addition, in the 26-week important analysis of PFS after irAE, similar results were observed, but similar results were not observed in the 26-week analysis of OS after irAE

In summary, after the occurrence of irAE, early use of high-dose GCC is associated with poor PFS and OS prognosis
.

In the process of anti-PD-1 monotherapy, GCC should be used more rationally

After the occurrence of irAE, early use of high-dose GCC is associated with poor PFS and OS prognosis After irAE occurs, early use of high-dose GCC is associated with poor PFS and OS prognosis

Original source:

Original source:

Xue Bai, Jiani Hu, Allison Betof Warner, et al.

Early use of high-dose-glucocorticoid for the management of irAE is associated with poorer survival in patients with advanced melanoma treated with monotherapy anti-PD-1 in this message