%0 Journal Article %T Impact of the corticosteroid indication and administration route on overall survival and the tumor response after immune checkpoint inhibitor initiation %+ Université de Picardie Jules Verne (UPJV) %+ Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux %+ CHU Amiens-Picardie %+ Service de dermatologie [CHU d'Amiens-Picardie] %+ Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV) %+ Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) %A Gaucher, Louis %A Adda, Leslie %A Sejourne, Alice %A Joachim, Camille %A Chaby, Guillaume %A Poulet, Claire %A Liabeuf, Sophie %A Gras-Champel, Valerie %A Masmoudi, Kamel %A Moreira, Aurelie %A Bennis, Youssef %A Batteux, Benjamin %< avec comité de lecture %@ 1758-8340 %J Therapeutic Advances in Medical Oncology %I SAGE Journals %V 13 %8 2021 %D 2021 %R 10.1177/1758835921996656 %Z Life Sciences [q-bio]Journal articles %X Background: Based on their indications, systemic corticosteroids appear to negatively affect clinical outcomes in immune checkpoint inhibitor (ICI)-treated patients. There are few data on the influence of topical and inhaled corticosteroids on the ICIs' effectiveness. Methods: In a single-center study, we retrospectively investigated the impact of systemic corticosteroids according to their indication [an immune-related adverse event (irAE) or another indication] on overall survival (OS) and the tumor response in all consecutive patients after initiation of ipilimumab, nivolumab or pembrolizumab over a 9-year period. The impacts of topical and inhaled corticosteroids were also examined. Results: Three hundred and seventy-two patients were included. The mean +/- standard deviation age was 64.0 +/- 12.1 years. The most frequently prescribed ICI was nivolumab (in 58.3% of the patients) and the most frequent indications were lung cancer (44.6%) and melanoma (29.6%). Systemic corticosteroid use for an irAE did not have a negative impact on OS [adjusted hazard ratio (HR) [95% confidence interval (CI)] 1.04 (0.56-1.95), p = 0.902] or the best overall tumor response [adjusted odds ratio (OR) (95% CI) 1.69 (0.52-6.56), p = 0.413], while systemic corticosteroid use for another indication was associated with shorter OS [adjusted HR (95% CI) 1.34 (1.05-2.03), p = 0.046] and a poor best overall tumor response [adjusted OR (95% CI) 2.04 (1.07-5.80), p = 0.039] with a cumulative dose cut-off of 3215 mg prednisolone equivalent (specificity 71.4%; sensitivity 65.3%) and a time cut-off of 132 days (specificity 71.4%; sensitivity 89.8%). The use of topical corticosteroids was associated with a longer OS; this was probably due to dermatological irAEs. Inhaled corticosteroid use did not influence OS. Conclusion: Systemic corticosteroid use for an irAE does not impact OS or the tumor response, whereas use for other indications (themselves often associated with a worse prognosis) does. Topical and inhaled steroids do not have a negative impact on OS. %G English %L hal-03564796 %U https://u-picardie.hal.science/hal-03564796 %~ UNIV-PICARDIE %~ INRAE %~ U-PICARDIE %~ MP3CV