ArticleCancer research communications2025
Impact of Glucocorticoids on Immune Checkpoint Inhibitor Efficacy and Circulating Biomarkers in Non-Small Cell Lung Cancer Patients.
Article in Cancer research communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Prednisolone modulates CD8⁺ and regulatory T-cell activity to dampen response to immune checkpoint inhibitor therapy in melanoma.Oncoimmunology · 2026Article
- Neuroimmune crosstalk in cancer: emerging immunotherapeutic opportunities.Journal for immunotherapy of cancer · 2026Review
- Developing neoantigen cancer vaccines: where are we now?Nature communications · 2026Review
- Metabolic adaptations of the tumor macroenvironment and their role in cancer progression and survivorship.Genes & development · 2026Review
- Thymulin restrains age-associated myeloid inflammation and enhances cancer immunotherapy.Nature communications · 2026Article
- The price of immune awakening: bridging knowledge gaps in checkpoint inhibitor-related pneumonitis in lung cancer.Breathe (Sheffield, England) · 2026Article
- The management of rheumatic immune related adverse events.Best practice & research. Clinical rheumatology · 2026Review
- Knowledge, perceptions and attitudes toward diabetes care in oncology: a pilot survey across specialties (DiaLog Study).Endocrine · 2026Article
- Lymphocyte CD4/CD8 ratio predicts early immune-related toxicity in lung cancer patients treated with immune checkpoint inhibitors: a single-center retrospective study.Frontiers in medicine · 2026Article
- Precision Management of Tumor-Associated Fever: From Classification to Targeted Intervention.Cancer management and research · 2026Review
- Independent Risk Factors and Nomogram-Based Prediction of Pulmonary Fungal Infection in Lung Cancer Inpatients: A Single-Center Retrospective Study.Cancer management and research · 2026Article
- Dual-edged therapy: corticosteroids in the era of immunotherapy.Immunotherapy · 2025Article
- Severe systemic cutaneous adverse reactions following camrelizumab therapy: a case report and literature review.Frontiers in immunology · 2025Review
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20 authors.
Funding
Abstract
Corticosteroids are frequently prescribed to patients with non-small cell lung cancer (NSCLC) for palliation of cancer-related symptoms; however, the potential impact of baseline steroid use on immune checkpoint inhibitor (ICI) therapy and its underlying mechanisms remain unclear. In this study, we evaluated clinical outcomes of 277 patients with NSCLC treated with ICI therapy at two academic institutions. Twenty-one patients (8%) were taking steroids at the start of ICIs. Patients on baseline steroids had a lower overall response rate with markedly shorter progression-free survival and overall survival compared with those not receiving steroids. In multivariate analysis, steroid use was the only significant independent risk factor for disease progression and mortality in both independent cohorts, Roswell Park Comprehensive Cancer Center (n = 88) and University of Southern California (n = 189). A baseline peripheral blood neutrophil-to-lymphocyte ratio <5 was a strong prognostic indicator; however, the prognostic value of neutrophil-to-lymphocyte ratio was absent in patients receiving steroids. Additionally, the baseline frequency of circulating CX3CR1+CD8+ T cells was substantially lower in patients on steroids. Using a bedside-to-bench approach, we found that concurrent steroid use significantly decreased antitumor efficacy of anti-PD-1 therapy and attenuated the increase of CX3CR1+CD8+ T cells in mice bearing MC38 tumors whereas discontinuation of steroid at the start of treatment did not make a negative impact on survival. Collectively, baseline steroid use was associated with worse outcomes and decreased frequency of circulating differentiated effector T cells in patients with NSCLC. Caution should be taken when interpreting the results from circulating immune-related biomarkers in patients on steroids. SIGNIFICANCE: The impact of corticosteroids, widely prescribed for palliation of cancer-related symptoms, on ICI therapy remains unclear. This study shows that baseline steroid use is a negative independent prognostic factor in patients with NSCLC undergoing ICI therapy and provides insights into the decreased T-cell effector differentiation and utility of predictive blood-based markers by steroids.
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