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.