In addition, patients with STK11 mutations tended to live shorter without progression (PFS) than those with STK11 feral cats. In patients who underwent KRAS mutations, STK11 mutations were also associated with a lower 12-month overall survival rate (OS).
The researchers analyzed the results of patients with 3b / 4 NSCLC level tested for STK11 mutation and were treated with point-of-care immunosuppressants between July 2014 and November 2019. In addition on determining the role of STK11 mutations and whether irAEs predicted response immunotherapy, the authors also wanted to determine the frequency of STK11 mutations and irAEs among Hispanic and non-Hispanic patients.
The study population included 96 patients who were SKT11 wildtype and 31 with SKT11 mutation, each group had a median age of 65 at the time of diagnosis. Forty-eight patients experienced irAE (median age, 70 years) and 77 were irAE-negative patients (median age, 66 years). In total, 30 Hispanic patients were involved: 8 had damage to the SKT11 mutation, and 14 experienced irAE.
Results Wildtype STK11-Mutant Versus SKT11
Mean OS was higher in STK11 wildtype patients than in STK11-mutant patients (12.1 months versus 8.6 months, respectively; P.= 0.03). Twelve-month OS was also higher with the wildtype group (73% vs. 55%; P.= 0.03). Patients with STK11 wildfire had slightly higher moderate PFS (6.3 months versus 5.6 months) and 12-month PFS (45% vs. 43%), although these results were not statistically significant (P.= 0.35 and P.= 0.85, respectively).
When it came to combined STK11 and KRAS mutations, patients with STK11 wildtype had a higher level of 12-month OS than those with the STK11 mutation (70% vs. 40%, respectively, P.= 0.03).
However, OS results were not statistically significant (11.4 months versus 5.3 months; P.= 0.13), and PFS results were not in the KRAS-mutant group. Medium PFS in the SKT11 wildtype group was 5.1 months and in the SKT11 group was 3 months.
Consequences of an immune-related adverse event
Patients who received irAE had statistically significant SDP and OS results.
Those with irAE had an average SDP at 9.5 months, compared with 4.4 months in those without (P.= 0.005). Twelve-month SDP was also better in those with irAE than in those without (60% versus 33%, respectively; P.= 0.0001).
When it came to OS, the average OS was 14.2 months in the irAE-positive group and 7.3 months in the irAE-negative group (P.<0.001). Twelve-month OS was also higher in the group with irAE, at 85%, compared with those without, 60% (P.= 0.00008).
The most common irAEs were hypothyroidism, which 35.7% of Hispanic patients experienced irAE-positive and 14.7% of non-Hispanic irAE patients; broth (21.4% and 29.4%); and pneumonitis (7.1% and 5.9%).
The authors note that the results indicate that irAE may be useful in identifying potential respondents in treatment. Therefore, they urge providers to monitor these events and manage them carefully to maximize the benefits of treatment while minimizing risks.
They also said their findings should be re-evaluated in larger studies in the future.
Information
Raez Le, Uba R, Tuath A, et al. Mutations of STK11 / LKB1, KRAS and immune-related adverse events as predictors of immunotherapy response in lung cancer. Presented at: 2021 World Conference on Lung Cancer Singapore, January 28-31, 2021.