Serial interferon-gamma release assay in lung cancer patients receiving immune checkpoint inhibitors: a prospective cohort study
Serial interferon-gamma release assay in lung cancer patients receiving immune checkpoint inhibitors: a prospective cohort study
Recent advancements in cancer immunotherapy using immune checkpoint inhibitors (ICIs) have received considerable attention. Although advantageous, ICI therapies cause unique immune-related adverse events (irAEs) in some patients. Moreover, infectious diseases, such as tuberculosis, have been recognized as emerging concerns during immunotherapy. We aimed to evaluate the interferon-gamma release assay (IGRA) conversion rate and active tuberculosis incidence during immunotherapy to elucidate the incidence of tuberculosis reactivation after ICI therapy induction. We prospectively assessed IGRA results in lung cancer patients who received ICI monotherapy before ICI treatment and at 6 and 12 months after ICI treatment. We also assessed computed tomography findings to determine the presence of active tuberculosis when positive IGRA results were obtained. The ICIs used were nivolumab, pembrolizumab, atezolizumab, and durvalumab. In all, 178 patients were prospectively recruited between March 2017 and March 2020. Of these, 123 completed serial IGRAs, of whom 18, 101, and 4, respectively, had positive, negative, and indeterminate IGRAs at baseline. Three and four patients, respectively, showed IGRA reversion and conversion during immunotherapy. One patient with a sustained, stable positive IGRA and one with IGRA conversion developed active pulmonary tuberculosis during immunotherapy. We found that 3.3% and 1.6% of the patients developed IGRA conversion and active tuberculosis, respectively. Of the four patients who developed IGRA conversion, one developed active pulmonary tuberculosis during immunotherapy. Another patient with sustained, stable positive IGRA developed active tuberculosis. Physicians should be alert to tuberculosis development during ICI therapy, and IGRA testing is a useful tool to assess the risk of developing active tuberculosis.
Conversion rate, IGRA, Immune checkpoint inhibitors, Tuberculosis
2757-2764
Fujita, Kohei
601c9a66-6e07-4089-adfb-4cd14107ec14
Elkington, Paul
60828c7c-3d32-47c9-9fcc-6c4c54c35a15
Redelman-Sidi, Gil
07b8a37e-f92a-4db9-8825-c7b260282f82
Kanai, Osamu
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Yamamoto, Yuli
76eff966-ad4b-4762-b072-208df21b975e
Imakita, Takuma
bb95c40d-4894-4012-aa3b-903e22194d0a
Okamura, Misato
fc5acfab-6d2e-4630-9279-1edd9b961e17
Nakatani, Koichi
ac34b76f-7421-428a-a8b5-448f5cf7ce8b
Mio, Tadashi
9d63572a-b562-4525-807e-e7d90dde2d29
November 2022
Fujita, Kohei
601c9a66-6e07-4089-adfb-4cd14107ec14
Elkington, Paul
60828c7c-3d32-47c9-9fcc-6c4c54c35a15
Redelman-Sidi, Gil
07b8a37e-f92a-4db9-8825-c7b260282f82
Kanai, Osamu
b44c0cc7-2ae3-4ea4-978e-2183889e3b6d
Yamamoto, Yuli
76eff966-ad4b-4762-b072-208df21b975e
Imakita, Takuma
bb95c40d-4894-4012-aa3b-903e22194d0a
Okamura, Misato
fc5acfab-6d2e-4630-9279-1edd9b961e17
Nakatani, Koichi
ac34b76f-7421-428a-a8b5-448f5cf7ce8b
Mio, Tadashi
9d63572a-b562-4525-807e-e7d90dde2d29
Fujita, Kohei, Elkington, Paul, Redelman-Sidi, Gil, Kanai, Osamu, Yamamoto, Yuli, Imakita, Takuma, Okamura, Misato, Nakatani, Koichi and Mio, Tadashi
(2022)
Serial interferon-gamma release assay in lung cancer patients receiving immune checkpoint inhibitors: a prospective cohort study.
Cancer Immunology Immunotherapy, 71 (11), .
(doi:10.1007/s00262-022-03198-1).
Abstract
Recent advancements in cancer immunotherapy using immune checkpoint inhibitors (ICIs) have received considerable attention. Although advantageous, ICI therapies cause unique immune-related adverse events (irAEs) in some patients. Moreover, infectious diseases, such as tuberculosis, have been recognized as emerging concerns during immunotherapy. We aimed to evaluate the interferon-gamma release assay (IGRA) conversion rate and active tuberculosis incidence during immunotherapy to elucidate the incidence of tuberculosis reactivation after ICI therapy induction. We prospectively assessed IGRA results in lung cancer patients who received ICI monotherapy before ICI treatment and at 6 and 12 months after ICI treatment. We also assessed computed tomography findings to determine the presence of active tuberculosis when positive IGRA results were obtained. The ICIs used were nivolumab, pembrolizumab, atezolizumab, and durvalumab. In all, 178 patients were prospectively recruited between March 2017 and March 2020. Of these, 123 completed serial IGRAs, of whom 18, 101, and 4, respectively, had positive, negative, and indeterminate IGRAs at baseline. Three and four patients, respectively, showed IGRA reversion and conversion during immunotherapy. One patient with a sustained, stable positive IGRA and one with IGRA conversion developed active pulmonary tuberculosis during immunotherapy. We found that 3.3% and 1.6% of the patients developed IGRA conversion and active tuberculosis, respectively. Of the four patients who developed IGRA conversion, one developed active pulmonary tuberculosis during immunotherapy. Another patient with sustained, stable positive IGRA developed active tuberculosis. Physicians should be alert to tuberculosis development during ICI therapy, and IGRA testing is a useful tool to assess the risk of developing active tuberculosis.
Text
CIIM_author_accepted
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More information
Accepted/In Press date: 30 March 2022
e-pub ahead of print date: 16 April 2022
Published date: November 2022
Additional Information:
Funding Information:
This work was supported in part by an annual contract research grant from the National Hospital Organization and a Grant-in-Aid for Young Scientists (B), KAKENHI, Japan Society for the Promotion of Science, Japan (grant number 17K16067).
Keywords:
Conversion rate, IGRA, Immune checkpoint inhibitors, Tuberculosis
Identifiers
Local EPrints ID: 456899
URI: http://eprints.soton.ac.uk/id/eprint/456899
ISSN: 0340-7004
PURE UUID: 74f21c43-a008-467f-b46c-4520430d203d
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Date deposited: 16 May 2022 16:41
Last modified: 17 Mar 2024 07:16
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Contributors
Author:
Kohei Fujita
Author:
Gil Redelman-Sidi
Author:
Osamu Kanai
Author:
Yuli Yamamoto
Author:
Takuma Imakita
Author:
Misato Okamura
Author:
Koichi Nakatani
Author:
Tadashi Mio
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