ArticleESMO open2019
Modulation of peripheral blood immune cells by early use of steroids and its association with clinical outcomes in patients with metastatic non-small cell lung cancer treated with immune checkpoint inhibitors.
Article in ESMO open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 125 papers, 7 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
125 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Clinical Outcomes of Immunosuppressant Drugs in Patients Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2026Pooled it
- Safety and effectiveness of immune checkpoint inhibitors in patients with preexisting autoimmune diseases: a systematic review.Frontiers in immunology · 2025Pooled it
- Impact of glucocorticoid administration on therapeutic outcomes of immune checkpoint inhibitors in non-small cell lung cancer: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Do corticosteroids affect immunotherapy efficacy in malignancy? - A systematic review.Cancer medicine · 2024Pooled it
- Do proton pump inhibitors alter the response to immune checkpoint inhibitors in cancer patients? A meta-analysis.Frontiers in immunology · 2023Pooled it
- Association of Brain Metastases With Immune Checkpoint Inhibitors Efficacy in Advanced Lung Cancer: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2021Pooled it
- Incidence rates of immune-related adverse events and their correlation with response in advanced solid tumours treated with NIVO or NIVO+IPI: a systematic review and meta-analysis.Journal for immunotherapy of cancer · 2019Pooled it
- Construction of the prognostic model for small-cell lung cancer based on inflammatory markers: A real-world study of 612 cases with eastern cooperative oncology group performance score 0-1.Cancer medicine · 2023Trial
- Preexisting autoimmune disease and immune-related adverse events associated with anti-PD-1 cancer immunotherapy: a national case series from the Canadian Research Group of Rheumatology in Immuno-Oncology.Cancer immunology, immunotherapy : CII · 2021Trial
- Early and High-Dose Glucocorticoid Use and Survival in Advanced NSCLC Receiving Immune Checkpoint Inhibitors: A Multicenter Target Trial Emulation.Clinical pharmacology and therapeutics · 2026Observational
- Oral glucocorticoid treatment for checkpoint inhibitor-associated inflammatory arthritis does not affect cancer progression-free survival: a RADIOS Registry study.Annals of the rheumatic diseases · 2026Observational
- Signaling Under Stress: Targeting the Glucocorticoid Receptor in Cancer.Cancer research · 2026Review
- Differential effects of prior versus concomitant Steroid and Antibiotic Treatment on Immunotherapy Efficacy - A Pooled Analysis of the RAMONA, INTEGA, OPTIM, ELDORANDO, FORCE, TITAN-RCC and TITAN-TCC Trials of the German AIO Study Group.British journal of cancer · 2026Article
- Host Determinants of Immune Checkpoint Inhibitor Efficacy: Immune, Genetic, Metabolic, and Lifestyle Factors.International journal of molecular sciences · 2026Review
- Hepatic immune-related adverse event increased the overall survival of patients with malignancies treated with immune checkpoint inhibitors.Hepatology international · 2025Article
- Tumour immune infiltration is independent of peripheral circulation of white blood cells in glioblastoma.Scientific reports · 2025Article
- Management of severe immune-related adverse events and outcomes in patients with advanced non-small cell lung cancer receiving immune checkpoint inhibitors.The oncologist · 2025Article
- [Update on the treatment of rheumatic immune-related adverse events under immune checkpoint inhibition].Zeitschrift fur Rheumatologie · 2025Review
- Review
- Impact of Glucocorticoids on Immune Checkpoint Inhibitor Efficacy and Circulating Biomarkers in Non-Small Cell Lung Cancer Patients.Cancer research communications · 2025Article
65 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSteroids are frequently used in patients with metastatic non-small cell lung cancer (mNSCLC), but they could be detrimental for patients treated with immune checkpoint inhibitors (ICIs). Here, we assessed the association between early use of steroids, clinical outcomes and peripheral immune blood cells modulation in patients with mNSCLC treated with ICIs.
methodsWe reviewed patients with mNSCLC treated at our institution between April 2013 and December 2017. Early use of steroids was defined as the use of a daily prednisone-equivalent dose ≥10 mg for at least 1 day within 28 days after ICI initiation. Peripheral immune blood cell counts were retrieved at baseline and at 4 and 6 weeks after ICI initiation.
resultsOut of 151 patients included, 35 (23%) made early use of steroids that was associated with poor disease control (OR 0.32, p=0.006), progression-free survival (HR 1.80, p=0.003) and overall survival (HR 2.60, p<0.001). Early use of steroids significantly correlated with higher median absolute neutrophil count, neutrophil to lymphocyte ratio (NLR) and derived NLR, and lower median absolute and relative eosinophil count, both at 4 and 6 weeks after ICI initiation.
conclusionsIn patients with mNSCLC treated with ICIs, early use of steroids was associated with worse clinical outcomes and remarkable modulation of peripheral blood immune cells, which could contribute to restraining the activation of antitumour immunity. If confirmed in prospective studies, these findings would highlight the importance of carefully evaluating and, whenever possible, avoiding steroids during early phases of ICI treatment.
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