Resposta terapêutica e efeitos laterais da imunoterapia em doentes com carcinoma pulmonar de não pequenas células

• Autor(a) principal: Filipe António Oliveira Veiga
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/128680
• topic: Medicina clínica; Clinical medicine

Introduction: Immunotherapy is nowadays one of the most used treatments in oncology, although it is not free of immune-related adverse effects (irAEs). In this study, we intended to analyse therapeutic response and irAEs of immunotherapy in a sample of patients with non-small lung cell carcinoma (NSCLC) treated with pembrolizumab or nivolumab. Material and methods: In this retrospective study, clinical data from patients with diagnose of metastasized NSCLC, treated with pembrolizumab or nivolumab, were collected between June 2015 and January 2020 at the Pulmonology Department of Centro Hospitalar e Universitário São João, Porto, Portugal. Results: Of a sample of 147 patients, 77 were treated with nivolumab and 70 with pembrolizumab. IrAEs occurred in 38 patients (25,9%), the majority being grade 1 or 2 (n=30). The most common events were colitis (n=9), skin rash (n=7) and hyperthyroidism (n=6). In patients treated with first-line immunotherapy (n=26), PFS and OS were, respectively, 7,3 (CI (95%): 4,1-11,2) and 8,7 months (CI (95%) : 5,1-13,2); in patients treated in 2nd line or higher (n=121), PFS and OS were 8,1 (CI (95%): 6,3-10,1) and 11,3 months (CI (95%): 9,3-13,4), respectively. PFS and OS were statistically higher in the group with irAEs compared to the group of patients without irAEs among patients treated in 1st line (PFS: 18,2 months (CI (95%): 5,0-31,5) vs. 4,8 months (CI (95%): 2,6-6,9); OS: 20,2 months (CI (95%): 7,5-34,5) vs. 6,0 months (CI (95%): 3,4-9,0)) and in 2nd line or higher (PFS: 14,1 months (CI (95%): 10,1-18,4) vs. 5,9 months (CI (95%): 4,3-7,6); OS: 18,3 months (CI (95%): 14,1-22,4) vs. 8,6 months (CI (95%): 6,8-10,6)), p<0,05. Discussion and Conclusion: Results suggest an association between the occurrence of irAEs and a better therapeutic response. However, further studies should be carried out for a better understanding of risk factors for the emergence of adverse events and the predictors of therapeutic response.