Associations Between Anxiety or Depression Diagnosis and Immune Checkpoint Inhibitor Outcomes.

Area of Science:

• Oncology
• Immunology
• Psychiatry

Background:

• Anxiety and depression can influence immune function, but their specific effects on immune checkpoint inhibitor (ICI) therapy outcomes remain unclear.
• Understanding these associations is crucial for optimizing cancer treatment strategies.

Purpose of the Study:

• To investigate the relationship between pre-existing anxiety or depression diagnoses and outcomes in patients undergoing anti-PD-1 or anti-PD-L1 monotherapy.
• To determine if these mental health conditions affect immune-related adverse events (irAEs), overall survival (OS), and time to treatment failure (TTF).

Main Methods:

• A secondary analysis of multicenter retrospective real-world data from patients receiving anti-PD-1 or anti-PD-L1 therapy.
• Key variables included anxiety/depression diagnosis at treatment initiation, irAEs, OS, TTF, and sociodemographic/clinical factors.

Main Results:

• Patients with an anxiety diagnosis showed a higher likelihood of experiencing irAEs (OR=1.80) and improved OS (HR=0.74) compared to those without.
• Depression diagnosis was not significantly associated with irAEs, OS, or TTF.
• In non-small cell lung cancer (NSCLC) patients, anxiety showed a trend toward better OS and longer TTF, with no significant difference in irAEs.

Conclusions:

• Pre-existing anxiety may significantly impact clinical outcomes for patients treated with anti-PD-1 or anti-PD-L1 therapies.
• Further translational and prospective research is needed to explore the links between psychosocial factors and ICI outcomes.