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Reimann, P.
Correlation of Metastasis Location and Outcome in Patients Treated with Checkpoint Inhibitors with NSCLC, RCC and Melanoma.
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2020. pp. 74
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Authors Med Uni Graz:
Advisor:: Gerger Armin
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Abstract:: Introduction: Checkpoint inhibitors play an increasingly important role in today’s cancer therapy. The effect of checkpoint inhibitors depends on many factors such as presence of immune cells in tumor metastases and tumor intrinsic properties. We investigated the association between metastatic site and outcome in patients treated with immune checkpoint inhibitors. Material and Methods: We retrospectively analyzed 103 patients from the Austrian cohort of the Alpine Tumor Immunology Registry (Alpine-TIR), with metastatic NSCLC (72 patients), metastatic RCC (16 patients) and metastatic melanoma (15 patients). Results: Among those patients 24.3% had bone, 20.4% liver, 31.1% lung, 17.5% suprarenal gland and 7.8% brain metastasis, respectively. The median overall survival from diagnosis to death for all patients was 52.3 month. In the univariate cox analysis, lung metastases (hazard ratio: 2.384, 95% confidence interval: 1.160 4.899; p=0.018) correlated with a significantly shorter overall survival. With overall survival calculated from commencing checkpoint inhibitor treatment to death, also liver metastases (hazard ratio 2.374, 95% confidence interval: 1.114 – 5.062; p=0.025) showed a significantly poorer prognosis. Other metastasis location such as suprarenal gland, bone and lymph nodes did not show a correlation. Conclusions: In conclusion, in the presented cohort, the efficacy of checkpoint inhibitors is dependent on the metastatic location. The existence of liver metastasis was associated with reduced overall survival from start of checkpoint inhibitor therapy, while lung metastasis showed a significantly poorer overall survival from diagnosis. This retrospective analysis demonstrated preliminary data for a predictive effect of location of metastasis in patients treated with immunotherapy.