Pembrolizumab well tolerated, improves outcomes in NSCLC patients with autoimmune disease

25 Jun 2023
Pembrolizumab well tolerated, effective in NSCLC with autoimmune disease

Use of pembrolizumab is well tolerated in nonsmall cell lung cancer (NSCLC) patients with previous autoimmune diseases, with a nonsignificant trend toward improved outcomes, reports a study.

In addition, completing the course of pembrolizumab is associated with better survival outcomes compared with noncompletion of the treatment.

A team of investigators conducted a retrospective case record review of 82 patients with tumours expressing programmed death-ligand 1 (PD-L1) with tumour proportion score (TPS) of ≥50 percent and treated with first-line pembrolizumab. The Kaplan-Meier method was used to estimate survival.

Median overall survival (OS) after follow-up (median 36.93 months) was 13.6 months (95 percent confidence interval [CI], 8.9‒19.3). Ten patients (12 percent) presented with autoimmune comorbidities. A trend toward better median OS was observed in this group compared with those without autoimmune comorbidity (42 vs 10.7 months; p=0.073).

Notably, 16 patients (20 percent) with nonprogressive disease at 2 years showed significantly better median OS than those who did not complete treatment (p<0.001).

More patients with autoimmune comorbidity developed immune-related adverse events (irAE) compared with those without (90 percent vs 70.8 percent). The only irAE that occurred at a significantly higher rate in the autoimmune group was low-grade adrenal insufficiency (p=0.02).

“Pembrolizumab, an immune-checkpoint inhibitor, is approved for first-line treatment of metastatic NSCLC in patients with tumours expressing PD-L1 with TPS of ≥50 percent,” the investigators noted.

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