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Cariou PL, Pobel C, Michot JM, Danlos FX, Besse B, Carbonnel F, Mariette X, Marabelle A, Messayke S, Robert C, Routier E, Noël N, Lambotte O. Impact of immunosuppressive agents on the management of immune-related adverse events of immune checkpoint blockers. Eur J Cancer 2024; 204:114065. [PMID: 38643707 DOI: 10.1016/j.ejca.2024.114065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Immune checkpoint blockers (ICBs) can induce immune-related adverse events (irAEs) whose management is based on expert opinion and may require the prescription of steroids and/or immunosuppressants (ISs). Recent data suggest that these treatments can reduce the effectiveness of ICBs. OBJECTIVE To investigate the relationship between the use of steroids and/or ISs and overall survival (OS) and progression-free survival (PFS) among ICB-treated patients with an irAE. METHODS We prospectively collected data from the medical records of patients with solid tumors or lymphoma in the French REISAMIC cohort and who had been treated with ICBs between June 2014 and June 2020. RESULTS 184 ICB-treated patients experienced at least one Common Terminology Criteria for Adverse Events grade ≥ 2 irAE. 107 (58.2%) were treated with steroids alone, 20 (10.9%) with steroids plus IS, 57 (31.0%) not received steroids or IS. The median OS was significantly shorter for patients treated with steroids alone (25.2 months [95% confidence interval (CI): 22.3-32.4] than for patients treated without steroids or IS (63 months [95%CI: 40.4-NA]) and those receiving an IS with steroids (53.4 months [95%CI: 47.3-NA]) (p < 0.001). The median PFS was significantly shorter for patients treated with steroids alone (17.0 months [95%CI: 11.7-22.9]) than for patients treated without steroids or IS (33.9 months [95%CI: 18.0-NA]) and those receiving an IS with steroids (41.1 months [95%CI: 26.2-NA]) (p = 0.006). There were no significant intergroup differences in the hospital admission and infection rates. CONCLUSION In a prospective cohort of ICB-treated patients, the use of IS was not associated with worse OS or PFS, contrasting with the use of steroids for the management of irAEs.
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Affiliation(s)
- Pierre-Louis Cariou
- Université Paris Saclay, AP-HP, Hôpital de Bicêtre, Department of Internal Medicine, UMR 1184, CEA INSERM, FHU CARE, Le Kremlin Bicêtre, France
| | - Cédric Pobel
- Drug Development Department (DITEP), Gustave Roussy, 94805 Villejuif, France
| | - Jean-Marie Michot
- Drug Development Department (DITEP), Gustave Roussy, 94805 Villejuif, France
| | | | - Benjamin Besse
- Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| | - Franck Carbonnel
- AP-HP, Department of Gastroenterology, University Hospital of Bicêtre, Paris Sud University, FHU CARE, 78 Rue du General Leclerc, 94270 Le Kremlin-Bicetre, France
| | - Xavier Mariette
- Université Paris-Saclay, AP-HP, Hôpital Bicêtre, Rheumatology Department, INSERM UMR 1184, FHU CARE, Paris, Le Kremlin Bicêtre, France
| | - Aurélien Marabelle
- Drug Development Department (DITEP), Gustave Roussy, 94805 Villejuif, France
| | - Sabine Messayke
- Gustave Roussy - Paris-Saclay University, Pharmacovigilance Unit, 94800 Villejuif, France
| | - Caroline Robert
- Dermatology Service, Department of Medicine, Gustave Roussy and Paris-Saclay University, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Emilie Routier
- Dermatology Service, Department of Medicine, Gustave Roussy and Paris-Saclay University, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Nicolas Noël
- Université Paris Saclay, AP-HP, Hôpital de Bicêtre, Department of Internal Medicine, UMR 1184, CEA INSERM, FHU CARE, Le Kremlin Bicêtre, France
| | - Olivier Lambotte
- Université Paris Saclay, AP-HP, Hôpital de Bicêtre, Department of Internal Medicine, UMR 1184, CEA INSERM, FHU CARE, Le Kremlin Bicêtre, France.
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Camard M, Besse B, Cariou PL, Massayke S, Laparra A, Noel N, Michot JM, Ammari S, Pavec JL, Lambotte O. Prevalence and outcome of steroid-resistant/refractory pneumonitis induced by immune checkpoint inhibitors. Respir Med Res 2022; 82:100969. [DOI: 10.1016/j.resmer.2022.100969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022]
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Pineton de Chambrun M, Cohen-Aubart F, Donker DW, Cariou PL, Luyt CE, Combes A, Amoura Z. SARS-CoV-2 Induces Acute and Refractory Relapse of Systemic Capillary Leak Syndrome (Clarkson's Disease). Am J Med 2020; 133:e663-e664. [PMID: 32405072 PMCID: PMC7217792 DOI: 10.1016/j.amjmed.2020.03.057] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Marc Pineton de Chambrun
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Service de Médecine Intensive-Réanimation, Hôpital La Pitié-Salpêtrière, Paris, France; Sorbonne Université, APHP, Institut E3M, Service de Médecine Interne 2, Centre de Référence National Lupus Systémique et SAPL et Autres Maladies Auto-immunes et Systémiques Rares, Hôpital de la Pitié-Salpêtrière, Paris, France; Sorbonne Universite, INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and Nutrition, (ICAN) Paris, France.
| | - Fleur Cohen-Aubart
- Sorbonne Université, APHP, Institut E3M, Service de Médecine Interne 2, Centre de Référence National Lupus Systémique et SAPL et Autres Maladies Auto-immunes et Systémiques Rares, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Dirk W Donker
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Service de Médecine Intensive-Réanimation, Hôpital La Pitié-Salpêtrière, Paris, France
| | - Pierre-Louis Cariou
- Sorbonne Université, APHP, Institut E3M, Service de Médecine Interne 2, Centre de Référence National Lupus Systémique et SAPL et Autres Maladies Auto-immunes et Systémiques Rares, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Charles-Edouard Luyt
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Service de Médecine Intensive-Réanimation, Hôpital La Pitié-Salpêtrière, Paris, France; Sorbonne Universite, INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and Nutrition, (ICAN) Paris, France
| | - Alain Combes
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Service de Médecine Intensive-Réanimation, Hôpital La Pitié-Salpêtrière, Paris, France; Sorbonne Universite, INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and Nutrition, (ICAN) Paris, France
| | - Zahir Amoura
- Sorbonne Université, APHP, Institut E3M, Service de Médecine Interne 2, Centre de Référence National Lupus Systémique et SAPL et Autres Maladies Auto-immunes et Systémiques Rares, Hôpital de la Pitié-Salpêtrière, Paris, France
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