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editorial
. 2019 Dec;8(Suppl 4):S364–S368. doi: 10.21037/tlcr.2019.06.06

Table 1. Retrospective studies assessing the impact of baseline corticosteroids on the clinical outcome of advanced NSCLC treated with PD-(L)1 inhibitors.

Author Type of study Number of patients Definition of steroid treatment Immune checkpoint inhibitor Reason for steroid use Median overall survival (steroid vs. non-steroid users) Significant covariates in multivariate analysis
Steroids No steroids
Arbour et al. (4) Multicentric 90 550 Oral or intravenous corticosteroids equivalent to prednisone >10 mg/day on the day starting ICI treatment Nivolumab; atezolizumab; pembrolizumab; durvalumab Dyspnea or respiratory symptoms (33%) IGR: 3.3 vs. 9.4 months, P<0.001 ECOG PS ≥2
Fatigue (21%) MSKCC: 5.4 vs. 12.1 months, P<0.001 Brain metastases
Brain metastases (19%) Corticosteroid >10 mg/day of prednisone or equivalent
Scott et al. (5) Single institution 66 144 Oral or intravenous corticosteroids equivalent to prednisone >10 mg/day at initiation or within 30 days after ICI treatment Nivolumab COPD or respiratory symptoms (21%) 4.3 vs. 11 months, P=0.017 Age
Disease-related pain and constitutional symptoms (18%)
irAE (17%) Corticosteroid >10 mg/day of prednisone or equivalent
Brain metastases (27%)
Fucà et al. (3) Single institution 35 116 Oral or intravenous corticosteroids equivalent to prednisone >10 mg/day for at least 1 day within 28 days after ICI treatment Anti-CTLA-4 + anti-PD-L1: 6 patients NA 4.86 vs. 15.14 months, P<0.001 ECOG PS ≥2
Single agent anti-PD-(L)1: 145 patients Corticosteroid >10 mg/day of prednisone or equivalent

COPD, chronic obstructive pulmonary disease; ECOG PS, Eastern Cooperative Oncology Group performance status; ICI, immune checkpoint inhibition; IGR, Institute Gustav Roussy; irAE, immune-related adverse event; mOS, median overall survival; NA, not available; PD-L1, programmed death-ligand 1; PD-1, programmed cell death-1; MSKCC, Memorial Sloan Kettering Cancer Center.