Evidence map›Paper›PMID 35607930›Full record

ArticleCancer medicine2023

Impact of concomitant fibrates on immunotherapy outcomes for advanced non-small cell lung cancer.

William A Stokes, Madhusmita Behera, Renjian Jiang, David A Gutman, Zhonglu Huang, Abigail Burns, Nikhil T Sebastian, Vidula Sukhatme, Michael C Lowe, Suresh S Ramalingam and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 8 citations in OpenAlex.

  1. Review
  2. Impact of comorbidity on survival in cancer patients receiving immune checkpoint inhibitors.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

William A StokesDepartment of Radiation Oncology, Emory University, Atlanta, Georgia, USA.ORCID 0000-0002-1616-7046
Madhusmita BeheraWinship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Renjian JiangWinship Cancer Institute, Emory University, Atlanta, Georgia, USA.
David A GutmanWinship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Zhonglu HuangWinship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Abigail BurnsAtlanta Veterans Affairs Health Care System, Decatur, Georgia, USA.
Nikhil T SebastianDepartment of Radiation Oncology, Emory University, Atlanta, Georgia, USA.ORCID 0000-0002-3977-7867
Vidula SukhatmeMorningside Center for Innovative and Affordable Medicine, Emory University, Atlanta, Georgia, USA.
Michael C LoweMorningside Center for Innovative and Affordable Medicine, Emory University, Atlanta, Georgia, USA.
Suresh S RamalingamWinship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Vikas P SukhatmeMorningside Center for Innovative and Affordable Medicine, Emory University, Atlanta, Georgia, USA.
Drew MoghanakiDepartment of Radiation Oncology, University of California Los Angeles, Los Angeles, California, USA.
Emory University · USAtlanta VA Health Care System · USUniversity of California, Los Angeles · US

Funding

U.S. Department of Veterans Affairs
6 · The paper itself

Abstract

backgroundPeroxisome proliferator-activated receptor agonists such as fibrates restore oxidative metabolism in cytotoxic T-lymphocytes, thereby enhancing response to immune checkpoint inhibitors (ICI) in preclinical models. However, there is no evidence in humans on the clinical impact of fibrates as an adjunct to ICI.

methodsIn this cohort study of Veterans with non-small cell lung cancer (NSCLC) receiving ICI, fibrate exposure was defined as a prescription filled within 90 days of an ICI infusion. Overall survival (OS), measured from the start of ICI, was compared between exposed and unexposed Veterans. Cox multivariable analysis (MVA) was used to identify factors associated with OS. A sensitivity analysis of Veterans with stage IV NSCLC who received docetaxel without ICI was similarly performed.

resultsThe ICI cohort included 3593 Veterans, of whom 301 (8.5%) coincidentally received a fibrate. Veterans receiving fibrates were more likely to be older, white, male, and married, and to have greater comorbidity burden, but less likely to receive chemotherapy. Coincidental fibrates were associated with improved OS both on MVA (HR 0.86, 95%CI 0.75-0.99) and in a matched subset (HR 0.75, 95%CI 0.63-0.90). In contrast, among the cohort of 968 Veterans treated with chemotherapy, fibrates did not have a significant impact on OS by MVA (HR 0.99, 95%CI 0.79-1.25) or in a matched subset (HR 1.02, 95%CI CI 0.75-1.39).

conclusionsConcomitant fibrates are associated with improved OS among NSCLC patients receiving ICI but not among those receiving chemotherapy. This hypothesis-generating observation supports a potential role for fibrates as an adjunct to immunotherapy.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsCohort StudiesFibric AcidsHumansImmunotherapyMaleRetrospective StudiesFibric Acidsfibratesimmune checkpoint inhibitorsperoxisome proliferator-activated receptor (PPAR) agonists

Identifiers

PMID35607930
PMCPMC9844615
OpenAlexW4282933582

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.