Endocrine toxicity as an independent predictor of response to immune checkpoint inhibitors in lung cancer patients

Lung cancer (LC) is the leading cause of cancer death worldwide. Survival outcomes have improved over time, due to the widespread adoption of therapeutic agents, including immune checkpoint inhibitors (ICIs). Endocrine immune-related adverse events (irAEs) are common in LC patients treated with ICIs. A retrospective study of LC patients was performed in a tertiary center for cases seen between January 2014 and October 2023. In total, 983 LC patients were included in the study, with a median age of 67 years. Median overall survival (OS) was higher in LC patients who experienced an endocrine irAE compared to those who did not (31.6 vs. 10.8 months, hazard ratio [HR]: 0.36, 95% CI: 0.28 - 0.46, p =1.56× 10-15). Median progression-free survival (PFS) was also higher (10.7 vs. 3.8 months, HR: 0.50, 95% CI:0.41 - 0.61, p=10-11). The survival difference remained statistically significant in the 3-month (HR: 0.42) and 6-month landmark analysis (HR: 0.51) and during multivariate analysis (HR: 0.48). The OS advantage in patients with endocrine irAEs was observed in both NSCLC (HR: 0.36) and SCLC patients (HR: 0.27). Additional research is needed to validate the role of endocrine irAEs as an independent predictor of survival outcomes in LC patients. <fig><object-id>erj;64/suppl_68/PA2421/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>