Impact of concomitant medication on clinical outcomes in patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors: A retrospective study.

BACKGROUND: It has recently been suggested that concomitant medication may affect the clinical outcome of patients treated with immune checkpoint inhibitors (ICIs). However, only a few studies on the impact of concomitant medication on immune-related adverse events (irAEs) have previously been reported. Here, we aimed to determine the impact of concomitant medication on the efficacy and safety of ICIs. METHODS: We retrospectively analyzed the data of 300 patients treated with nivolumab or pembrolizumab for advanced non-small cell lung cancer (NSCLC) between January 2016 and July 2018. Multivariate logistic regression analysis was used to assess the effect of concomitant medication on treatment response or irAEs. A multivariate Cox proportional hazards model was used to evaluate concomitant medication-related factors associated with time-to-treatment failure or overall survival (OS). RESULTS: A total of 70 patients responded to treatment and 137 experienced irAEs. The response rate and incidence of irAEs in patients treated with ICIs were not significantly associated with concomitant medication. Multivariate analysis showed that the use of opioids was an independent factor (time-to-treatment failure: hazard ratio 1.39, p = 0.021, OS: hazard ratio 1.54, p = 0.007). CONCLUSIONS: The efficacy and safety of nivolumab or pembrolizumab in the treatment of patients with advanced NSCLC were not significantly influenced by concomitant medication. However, opioid usage might be associated with shorter OS in patients treated with these ICIs. Further mechanistic investigations should explore whether these associations are purely prognostic or contribute to ICI resistance.

Longitudinal changes and body composition assessment using bioelectrical impedance in elderly patients with mild disequilibrium and different care needs.

[Purpose] This study involved performing longitudinal measurements of muscle mass in elderly patients with mild disequilibrium using a body composition meter. The rate of change and characteristics were determined according to the level of care needed. [Participants and Methods] Bioelectrical impedance was used to measure body composition in 20 elderly females in Care Needs Category 1 (n=10) and 2 (n=8); body composition was measured every 3 months for 1 year. [Results] Compared to Category 1, the muscle mass at each body site was lower in Category 2 and the muscle mass of the whole body and thighs in Category 2 decreased throughout the year. [Conclusion] Muscle mass in elderly patients needing assistance depended on the level of care, as suggested by the decrease in muscle mass in the whole body and thighs in Category 2 over time. In addition, effective rehabilitation intervention for the trunk is important.