Impact of dose modification of immune-checkpoint inhibitors in lung cancer patients during the COVID-19 pandemic

ABSTRACT

Background: COVID-19 pandemic has led physicians to change their practice in the treatment of non-small cell lung cancer (NSCLC) to reduce hospital stays of patients. Objective(s) We aimed to assess toxicity and efficacy of extended-interval (EI) dosing of immune checkpoint inhibitors (ICI) compared to standard dose (SD). Method(s) In a retrospective bicentric study, patients with stage III/IV NSCLC treated with ICI +/- pemetrexed in maintenance setting during the month before March 2020 were included. Immune-related adverse events (IRAE) and efficacy were collected until June 2021. Toxicity and survival were assessed using multivariate logistic regression and Cox models. Result(s) Among the 134 identified patients (8 stage III and 126 stage IV, 66 in 1st line and 60 in 2nd or further lines), 70.9% had an EI dosing. In the EI dosing group, 12.6% patients developed grade 3 or more IRAE and 15.4% in the SD group (p=0.8). Treatment was definitively discontinued for toxicity for 9 patients in the EI dosing group and 5 patients in the SD group (p=0.5). Overall survival was not associated with dosage or occurrence of toxicity as timedependent variable (Table). Conclusion(s) Our study suggests that EI dosing of ICI did not affect toxicity, efficacy and survival in NSCLC patients.