Do corticosteroids affect immunotherapy efficacy in malignancy? - A systematic review

Area of Science:

• Oncology
• Immunology
• Pharmacology

Background:

• Early research suggested corticosteroids might reduce immunotherapy benefits.
• This systematic review addresses the impact of corticosteroids on immunotherapy efficacy in cancer patients.
• The study specifically adjusts for corticosteroids used for palliative care.

Purpose of the Study:

• To evaluate the effect of corticosteroids on immunotherapy outcomes in cancer patients.
• To differentiate the impact of corticosteroids used for non-cancer indications versus palliative care.
• To synthesize evidence on corticosteroid use and immunotherapy response.

Main Methods:

• Systematic review and meta-analysis of studies from PubMed, Embase, and Medline.
• Included studies compared immunotherapy response/survival in patients receiving corticosteroids for non-cancer indications versus controls.
• Excluded studies solely on corticosteroids for immune-related adverse events (irAE). Pooled odds and hazard ratios were calculated.

Main Results:

• Eight studies were included in the meta-analysis.
• Corticosteroids for non-cancer indications showed no statistically significant effect on overall response rate (OR 1.01).
• No significant impact was observed on progression-free survival (HR 0.87) or overall survival (HR 0.79).

Conclusions:

• Corticosteroids for non-cancer indications do not appear to negatively affect immunotherapy response or survival.
• Results suggest that confounding effects from palliative corticosteroid use were successfully mitigated.
• Limitations include retrospective study designs, small sample sizes, and potential bias from irAE inclusion in some studies.