WHAT’S NEW?
By expanding the sample size, we found that the PD-1 inhibitor showed an
acceptable toxicity profile on NSCLC patients with chronic viral
infection. There is no big difference between the adverse reaction
spectrum and the incidence of adverse reactions in such patients and
those of patients without infectious diseases, but it is worth observing
that the proportion of hepatic transaminase elevating was increased.
Hepatic transaminase increased in 26.7% (16/60) of hepatitis B
patients. All five patients with reduced viral load received antiviral
therapy. Of the 14 patients who did not receive antiviral therapy, 3
patients had grade 3 or 4 adverse events, but in all three patients, the
adverse events were reversed with steroids and ICIs were not
discontinued, so the side effects were considered acceptable. And
immunotherapy combined with antiviral therapy can effectively improve
safety. Therefore, we recommend close monitoring for such patients in
consultation with a hepatologist and to treat those with active viral
hepatitis with antiviral therapy prior to the immunotherapy. The
efficacy of PD-1/PD-L1 immune checkpoint inhibitors on locally advanced
and advanced NSCLC patients with a history of infectious diseases was
acceptable and such patients can benefit from immunotherapy. In subgroup
analysis, first-line treatment group, immunotherapy combined with
radiotherapy group, immunotherapy combined with chemotherapy and
antiangiogenic agents group showed better efficacy.