immune-related adverse events (AEs) in lung cancer patients treated with PD-1/PD-L1 checkpoint inhibitors

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In addition to efficacy data from trials, our findings provide useful information for clinicians for well-balanced discussions with their patients on the risks and benefits of treatment options for advanced cancer…

I am a long-term cancer survivor and cancer coach. I see the studies linked and excerpted below differently than you oncologist. My view of conventional lung cancer therapies is that they offer a poor risk/reward proposition to cancer patients. Especially lung cancer (LC) patients. Conventional therapies, either traditional chemo or immunotherapies must be supported by evidence-based complementary and integrative therapies.

Image result for image of lung cancer surgery

I don’t mean to suggest that you face lung cancer treatment without conventional therapies at all. My experience is to combine conventional therapies such as immunotherapy with evidence-based, non-toxic, non-conventional therapies.

A good example of what I am talking about is pre-habilitating before your surgery, radiation or chemotherapy. And/or enhance your chemo with an integrative therapy such as curcumin.

Have you been diagnosed with lung cancer? What stage? Please scroll down the page, post a question or comment and I will reply to you ASAP.

thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Safety and Tolerability of PD-1/PD-L1 Inhibitors Compared with Chemotherapy in Patients with Advanced Cancer: A Meta-Analysis.

“We conducted a systematic review and meta-analysis to compare safety and tolerability between PD-1/PD-L1 inhibitors and chemotherapy…

A total of 3,450 patients from 7 RCTs were included in the meta-analysis: 4 nivolumab, 2 pembrolizumab, and 1 atezolizumab trials. The underlying malignancies included were non-small cell lung cancer (4 trials) and melanoma (3 trials). Compared with chemotherapy, the PD-1/PD-L1 inhibitors had a significantly lower risk of all- and high-grade fatigue, sensory neuropathy, diarrhea and hematologic toxicities, all-grade anorexia, nausea, and constipation, any all- and high-grade AEs, and treatment discontinuation. There was an increased risk of all-grade rash, pruritus, colitis, aminotransferase elevations, hypothyroidism, and hyperthyroidism, and all- and high-grade pneumonitis with PD1/PD-L1 inhibitors...

Flu Vaccine in Lung Cancer Patients Could Increase Immunotherapy Toxicities

“Seasonal influenza vaccination resulted in increased risk of immune-related adverse events (AEs) in lung cancer patients treated with PD-1/PD-L1 checkpoint inhibitors in a small study. However, the risks of the flu itself may still outweigh the risks associated with vaccination…

Although routine influenza vaccination has long been recommended for cancer patients, there are concerns that it might trigger an exaggerated immune response in this subgroup receiving checkpoint inhibitors…”

The vaccine was effective in all patients, with no reported cases of influenza. There was an unusually high frequency of immune-related AEs, however, occurring in 52.2% of patients; six patients (26.1%) had a grade 3 or 4 immune-related AE. The most common such AEs were skin rashes and arthritis (13% each), colitis and encephalitis (8.7% each), and hypothyroidism, pneumonitis, and neuropathy (4.3% each)…

“The frequency is significantly higher than the rate of immune-related AEs in unvaccinated patients treated with PD-1/PD-L1 inhibitors,” Rothschild said. At his center, the expected rate of such AEs would be about 25.5%; rates between 30% and 35% have been reported in the literature. “Our hypothesis is that the vaccine results in an overwhelming activation of the immune system in this population.” He added, though, that “there is a particular concern for severe complication of an influenza infection including pneumonia and respiratory failure for patients with lung cancer under immunotherapy….”



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