2021/07/16
Faculty of Pharmacy, Keio University
A research group led by Keio University, the National Cancer Center Hospital, and Keio University Hospital has discovered that peripheral blood lymphocyte counts can predict the onset of immune-related adverse events caused by immune checkpoint inhibitors. This study is the work of a multi-institutional collaborative research group centered at the National Cancer Center Hospital and Keio University Hospital, and includes Saeka Egami, a sixth-year student in the Department of Pharmacy, Faculty of Pharmacy, Keio University (at the time of the research); Hitoshi Kawazoe, Senior Assistant Professor at the same faculty; and Professor Tomonori Nakamura.
We now live in an era where one in two people will develop cancer, and one in three will die from it. Lung cancer, in particular, is the leading cause of death, with approximately 75,000 deaths annually. Nivolumab, an immune checkpoint inhibitor, is the standard treatment for advanced or recurrent non-small cell lung cancer. Immune-related adverse events from immune checkpoint inhibitors include skin disorders, diarrhea, thyroid dysfunction, and interstitial lung disease. These are side effects that can occur in anyone, and it is not known when they will happen. Therefore, the early detection and management of "high-risk patients" are extremely important.
In this study, we hypothesized that the onset of immune-related adverse events from nivolumab would correlate with peripheral blood cell counts. We conducted a retrospective review of medical records for patients who received nivolumab therapy for six weeks or more as a second-line or later treatment for advanced or recurrent non-small cell lung cancer at two institutions: the National Cancer Center Hospital and Keio University Hospital. Of the 171 eligible patients, 73 (42.7%) developed one or more immune-related adverse events within six weeks of starting treatment. Statistical analysis of various blood cell components revealed that the peripheral blood lymphocyte count at two weeks after the start of nivolumab therapy correlated with the onset of immune-related adverse events from the immune checkpoint inhibitor.
These findings suggest that measuring peripheral blood lymphocyte counts can predict the onset of immune-related adverse events from nivolumab. We believe these research results indicate the possibility of prospectively identifying immune-related adverse events from immune checkpoint inhibitors, which will lead to the early detection and management of "high-risk patients." The results of this study were published in the online edition of the international academic journal "Frontiers in Oncology" on May 27, 2021.
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