Evidence map›Paper›PMID 37486396›Full record

ArticleCancer immunology, immunotherapy : CII2023

Previous radiotherapy improves treatment responses and causes a trend toward longer time to progression among patients with immune checkpoint inhibitor-related adverse events.

Anna Jokimäki, Henna Hietala, Jasmiini Lemma, Hanna Karhapää, Anna Rintala, Jari-Pekka Kaikkonen, Kaisa Sunela, Eva Boman, Arja Jukkola, Satu Tiainen and 11 more

Abstract readMulticenter Study
In one paragraph

Article in Cancer immunology, immunotherapy : CII, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
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

21 authors.

Anna JokimäkiDepartment of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland. anna.jokimaki@pohde.fi.
Henna HietalaDepartment of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland.
Jasmiini LemmaDepartment of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.
Hanna KarhapääDepartment of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.
Anna RintalaDepartment of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.
Jari-Pekka KaikkonenFaculty of Medicine and Health Technology, Tampere Cancer Center, Tampere University, Tampere, Finland.
Kaisa SunelaDepartment of Oncology, Tampere University Hospital, Tampere, Finland.
Eva BomanDepartment of Oncology, Tampere University Hospital, Tampere, Finland.
Arja JukkolaFaculty of Medicine and Health Technology, Tampere Cancer Center, Tampere University, Tampere, Finland.
Satu TiainenCenter of Oncology, Kuopio University Hospital, Kuopio, Finland.
Jan SeppäläCenter of Oncology, Kuopio University Hospital, Kuopio, Finland.
Aino RönkäCenter of Oncology, Kuopio University Hospital, Kuopio, Finland.
Heikki HakkarainenDepartment of Oncology, Hospital of Central Finland Nova, Jyvaskyla, Finland.
Aarno KärnäDepartment of Oncology, Hospital of Central Finland Nova, Jyvaskyla, Finland.
Sanna IivanainenDepartment of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland.
Jussi KoivunenDepartment of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland.
Päivi AuvinenCenter of Oncology, Kuopio University Hospital, Kuopio, Finland.
Micaela HernbergDepartment of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.
Milla KuusistoMedical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
Tuomas SelanderScience Service Center, Kuopio University Hospital, Kuopio, Finland.
Outi KuittinenDepartment of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmune-related adverse events (irAEs) are frequently encountered by patients during immune checkpoint inhibitor (ICI) treatment and are associated with better treatment outcomes. The sequencing of radiotherapy (RT) and ICIs is widely used in current clinical practice, but its effect on survival has remained unclear.

methodsIn a real-world multicenter study including 521 patients who received ICI treatment for metastatic or locally advanced cancer, RT schedules and timing, irAEs, time to progression, overall survival, and treatment responses were retrospectively reviewed.

resultsPatients who received previous RT and developed irAE (RT +/AE +) had the best overall response rate (ORR 44.0%). The ORR was 40.1% in the RT -/AE + group, 26.7% in the RT -/AE - group and 18.3% in the RT + /AE - group (p < 0.001). There was a significantly longer time to progression (TTP) in the RT + /AE + group compared to the RT -/AE - and RT + /AE - groups (log rank p = 0.001 and p < 0.001, respectively), but the trend toward longer TTP in the RT + /AE + group did not reach statistical significance in pairwise comparison to that in the RT -/AE + group. Preceding RT timing and intent had no statistically significant effect on TTP. In a multivariate model, ECOG = 0 and occurrence of irAEs remained independent positive prognostic factors for TTP (HR 0.737; 95% CI 0.582-0.935; p = 0.012, and HR 0.620; 95% CI 0.499-0.769; p < 0.001, respectively).

conclusionsBetter ORR and a trend toward longer TTP were demonstrated for patients with RT preceding ICI treatment and development of irAEs, which suggests that RT may boost the therapeutic effect of immunotherapy in patients with metastatic cancers.

Indexed as

Immune Checkpoint InhibitorsNeoplasmsHumansImmunotherapyRetrospective StudiesImmune Checkpoint InhibitorsImmune checkpoint inhibitorsImmune-related adverse eventsOverall response rateRadiotherapy

Identifiers

PMID37486396
PMCPMC10491510

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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.