ICI therapy tied to reduced second primary cancer risk
medwireNews: People with cancer who receive treatment with immune checkpoint inhibitors (ICIs) may have a reduced risk for a second primary cancer, report French researchers.
“If confirmed, these results open a novel area of clinical research in tertiary prevention for cancer patients,” they write in a letter to the Annals of Oncology.
Jean-Yves Blay and colleagues from Centre Léon Bérard in Lyon analyzed the medical records of 46,829 patients diagnosed with a primary tumor, most commonly of the breast (25%) or lungs (10%), at their institution in 2013–2018. A total of 2.5% of participants received ICIs for the primary tumor.
Second primary cancers occurred in 3.9% of patients, but the incidence was significantly lower among individuals who had been treated with ICIs than those who had not, at 0.6% versus 4.0%.
And in multivariate analysis, receipt of ICIs was one of the significant predictors of a reduced risk for second primary cancer, along with young age, metastasis at time of first primary cancer diagnosis, and the histotype of the first tumor.
“These results are consistent across all histotypes and significant for each individual year of the study,” say the study authors.
Furthermore, in an analysis restricted to the 24,356 patients without metastatic disease, there were no second primary cancers among ICI-treated patients versus an incidence of 5.2% among those who did not receive ICIs, a significant difference. And once again, ICI treatment was significantly associated with a reduced risk for second primary cancer in multivariate analysis.
“These observations are consistent with meta-analysis of clinical trials of ICI where no or very few [second primary cancers] were reported,” conclude Blay et al, but they stress the need for longer follow-up to determine “whether this reduction is sustained over time.”
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