Title |
Early fatigue in cancer patients receiving PD-1/PD-L1 checkpoint inhibitors: an insight from clinical practice
|
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Published in |
Journal of Translational Medicine, November 2019
|
DOI | 10.1186/s12967-019-02132-x |
Pubmed ID | |
Authors |
Alessio Cortellini, Maria G. Vitale, Federica De Galitiis, Francesca R. Di Pietro, Rossana Berardi, Mariangela Torniai, Michele De Tursi, Antonino Grassadonia, Pietro Di Marino, Daniele Santini, Tea Zeppola, Cecilia Anesi, Alain Gelibter, Mario Alberto Occhipinti, Andrea Botticelli, Paolo Marchetti, Francesca Rastelli, Federica Pergolesi, Marianna Tudini, Rosa Rita Silva, Domenico Mallardo, Vito Vanella, Corrado Ficorella, Giampiero Porzio, Paolo A. Ascierto |
Abstract |
Fatigue was reported as the most common any-grade adverse event (18.3%), and the most common grade 3 or higher immune-related adverse event (irAE) (0.89%) in patients receiving PD-1/PD-L1 checkpoint inhibitors in clinical trial. The aim of this retrospective multicenter study was to evaluate the correlations between "early ir-fatigue", "delayed ir-fatigue", and clinical outcomes in cancer patients receiving PD-1/PD-L1 inhibitors in clinical practice. 517 patients were evaluated. After the 12-weeks landmark selection, 386 (74.7%) patients were eligible for the clinical outcomes analysis. 40.4% were NSCLC, 42.2% were melanoma, 15.3% renal cell carcinoma and 2.1% other malignancies. 76 patients (19.7%) experienced early ir-fatigue (within 1 month from treatment commencement), while 150 patients (38.9%) experienced delayed ir-fatigue. Early ir-fatigue was significantly related to shortened PFS (HR = 2.29 [95% CI 1.62-3.22], p < 0.0001) and OS (HR = 2.32 [95% CI 1.59-3.38], p < 0.0001) at the multivariate analysis. On the other hand, we found a significant association between the occurrence of early ir-fatigue, ECOG-PS ≥ 2 (p < 0.0001), and disease burden (p = 0.0003). Delayed ir-fatigue was not significantly related to PFS nor OS. Early ir-fatigue seems to be negative prognostic parameter, but to proper weight its role we must to consider the predominant role of performance status, which was related to early ir-fatigue in the study population. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 50% |
Unknown | 1 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 1 | 50% |
Science communicators (journalists, bloggers, editors) | 1 | 50% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 35 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 6 | 17% |
Student > Doctoral Student | 3 | 9% |
Researcher | 3 | 9% |
Student > Ph. D. Student | 2 | 6% |
Student > Postgraduate | 2 | 6% |
Other | 5 | 14% |
Unknown | 14 | 40% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 12 | 34% |
Biochemistry, Genetics and Molecular Biology | 3 | 9% |
Arts and Humanities | 1 | 3% |
Nursing and Health Professions | 1 | 3% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 3% |
Other | 2 | 6% |
Unknown | 15 | 43% |