Safety of thoracic radiotherapy after PD‐(L)1 inhibitor treatment in patients with lung cancer

Abstract Background The safety of thoracic radiotherapy (TRT) after programmed death 1/programmed death ligand 1 (PD‐(L)1) inhibitor treatment in patients with lung cancer was scarcely reported. This retrospective study was conducted to evaluate the incidence, severity, and risk factors of symptomat...

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Autores principales:	Yu Chen, Xinchao Liu, Zhaoqin Huang, Kaikai Zhao, Yao Wang, Fei Ren, Jinming Yu, Xiangjiao Meng
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	lung cancer PD‐(L)1 inhibitor pneumonitis safety thoracic radiotherapy (TRT) Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/ac1d2e6abb474baab5f2a2c63217a8f9
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spelling	oai:doaj.org-article:ac1d2e6abb474baab5f2a2c63217a8f92021-12-01T04:49:15ZSafety of thoracic radiotherapy after PD‐(L)1 inhibitor treatment in patients with lung cancer2045-763410.1002/cam4.4363https://doaj.org/article/ac1d2e6abb474baab5f2a2c63217a8f92021-12-01T00:00:00Zhttps://doi.org/10.1002/cam4.4363https://doaj.org/toc/2045-7634Abstract Background The safety of thoracic radiotherapy (TRT) after programmed death 1/programmed death ligand 1 (PD‐(L)1) inhibitor treatment in patients with lung cancer was scarcely reported. This retrospective study was conducted to evaluate the incidence, severity, and risk factors of symptomatic treatment‐related pneumonitis in patients with lung cancer who received this sequential combination. Methods We conducted a retrospective study of a cohort of patients with lung cancer who received TRT after at least two cycles of PD‐(L)1 inhibitor treatment between January 2018 and August 2020. Treatment‐related pneumonitis was evaluated and analyzed to illustrate the safety profile of this sequential combination. Potential risk factors were explored by univariate and multivariate logistic regression analyses. Results Among the 828 patients with prior PD‐(L)1 inhibitor treatment, 96 patients receiving subsequent TRT were included in the analysis. Of these, 49 patients (51%) received radical TRT while 47 patients (49%) received palliative TRT. The median total dose was 52 Gy (IQR 50–60 Gy). The median time from the initiation of PD‐(L)1 inhibitor treatment to TRT was 4.8 months (1.6–14.1 months) with most of the patients (74%) administering no less than four cycles of PD‐(L)1 inhibitor. During follow‐up, 47 patients (48.96%) developed symptomatic treatment‐related pneumonitis (grade 2 n = 28, grade ≥3 n = 19) while six patients (6.25%) suffered from fatal toxicity. The median time of pneumonitis onset after completion of TRT was 35 days (0–177 days) with six patients developing during TRT. Pulmonary emphysema and lung V20 were demonstrated to be independent risk factors of symptomatic pneumonitis (OR: 5.67, 95% CI: 1.66–19.37, p = 0.006; OR: 3.49, 95% CI: 1.41–8.66, p = 0.007, respectively). Conclusion TRT after PD‐(L)1 inhibitor treatment resulted in significantly increased incidence and severity of treatment‐related pneumonitis in patients with lung cancer. Intensive attention should be emphasized to the safety of this sequential combination in clinical practice.Yu ChenXinchao LiuZhaoqin HuangKaikai ZhaoYao WangFei RenJinming YuXiangjiao MengWileyarticlelung cancerPD‐(L)1 inhibitorpneumonitissafetythoracic radiotherapy (TRT)Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancer Medicine, Vol 10, Iss 23, Pp 8518-8529 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	lung cancer PD‐(L)1 inhibitor pneumonitis safety thoracic radiotherapy (TRT) Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	lung cancer PD‐(L)1 inhibitor pneumonitis safety thoracic radiotherapy (TRT) Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Yu Chen Xinchao Liu Zhaoqin Huang Kaikai Zhao Yao Wang Fei Ren Jinming Yu Xiangjiao Meng Safety of thoracic radiotherapy after PD‐(L)1 inhibitor treatment in patients with lung cancer
description	Abstract Background The safety of thoracic radiotherapy (TRT) after programmed death 1/programmed death ligand 1 (PD‐(L)1) inhibitor treatment in patients with lung cancer was scarcely reported. This retrospective study was conducted to evaluate the incidence, severity, and risk factors of symptomatic treatment‐related pneumonitis in patients with lung cancer who received this sequential combination. Methods We conducted a retrospective study of a cohort of patients with lung cancer who received TRT after at least two cycles of PD‐(L)1 inhibitor treatment between January 2018 and August 2020. Treatment‐related pneumonitis was evaluated and analyzed to illustrate the safety profile of this sequential combination. Potential risk factors were explored by univariate and multivariate logistic regression analyses. Results Among the 828 patients with prior PD‐(L)1 inhibitor treatment, 96 patients receiving subsequent TRT were included in the analysis. Of these, 49 patients (51%) received radical TRT while 47 patients (49%) received palliative TRT. The median total dose was 52 Gy (IQR 50–60 Gy). The median time from the initiation of PD‐(L)1 inhibitor treatment to TRT was 4.8 months (1.6–14.1 months) with most of the patients (74%) administering no less than four cycles of PD‐(L)1 inhibitor. During follow‐up, 47 patients (48.96%) developed symptomatic treatment‐related pneumonitis (grade 2 n = 28, grade ≥3 n = 19) while six patients (6.25%) suffered from fatal toxicity. The median time of pneumonitis onset after completion of TRT was 35 days (0–177 days) with six patients developing during TRT. Pulmonary emphysema and lung V20 were demonstrated to be independent risk factors of symptomatic pneumonitis (OR: 5.67, 95% CI: 1.66–19.37, p = 0.006; OR: 3.49, 95% CI: 1.41–8.66, p = 0.007, respectively). Conclusion TRT after PD‐(L)1 inhibitor treatment resulted in significantly increased incidence and severity of treatment‐related pneumonitis in patients with lung cancer. Intensive attention should be emphasized to the safety of this sequential combination in clinical practice.
format	article
author	Yu Chen Xinchao Liu Zhaoqin Huang Kaikai Zhao Yao Wang Fei Ren Jinming Yu Xiangjiao Meng
author_facet	Yu Chen Xinchao Liu Zhaoqin Huang Kaikai Zhao Yao Wang Fei Ren Jinming Yu Xiangjiao Meng
author_sort	Yu Chen
title	Safety of thoracic radiotherapy after PD‐(L)1 inhibitor treatment in patients with lung cancer
title_short	Safety of thoracic radiotherapy after PD‐(L)1 inhibitor treatment in patients with lung cancer
title_full	Safety of thoracic radiotherapy after PD‐(L)1 inhibitor treatment in patients with lung cancer
title_fullStr	Safety of thoracic radiotherapy after PD‐(L)1 inhibitor treatment in patients with lung cancer
title_full_unstemmed	Safety of thoracic radiotherapy after PD‐(L)1 inhibitor treatment in patients with lung cancer
title_sort	safety of thoracic radiotherapy after pd‐(l)1 inhibitor treatment in patients with lung cancer
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/ac1d2e6abb474baab5f2a2c63217a8f9
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Safety of thoracic radiotherapy after PD‐(L)1 inhibitor treatment in patients with lung cancer

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