"Fast First and Then Slowly" Steroid-Tapering Regimen in Managing Corticoid-Sensitive Patients With Severe Immunotherapy Complications After Anti-PD-(L)1 Therapy for Cancer

Qi Gui; Liping Xie; Shaoqi Cheng; Chengcheng Xu

doi:10.1177/11795549231210475

"Fast First and Then Slowly" Steroid-Tapering Regimen in Managing Corticoid-Sensitive Patients With Severe Immunotherapy Complications After Anti-PD-(L)1 Therapy for Cancer

Clin Med Insights Oncol. 2023 Nov 24:17:11795549231210475. doi: 10.1177/11795549231210475. eCollection 2023.

Authors

Qi Gui¹, Liping Xie¹, Shaoqi Cheng², Chengcheng Xu²

Affiliations

¹ Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, People's Republic of China.
² Departments of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.

Abstract

Background: We aimed to assess the efficacy of the "fast first and then slowly" steroid-tapering regimen used in managing corticoid-sensitive patients with severe irAE after anti-PD-(L)1 therapy. Corticosteroids are the primary therapy for severe immune-related adverse events (irAEs). Less is known about the standard steroid-tapering regimen for corticoid-sensitive patients.

Methods: This study was a single-center, retrospective medical record review of patients with severe irAE after anti-PD-(L)1 treatment for cancer from October 13, 2021 to October 20, 2022. The efficacy was assessed by Common Terminology Criteria for Adverse Events (CTCAE) grading system.

Results: Among the 187 patients with severe irAEs associated with immune checkpoint inhibitors (ICIs), 136 (72.7%) cases were corticoid-sensitive, and 96 (51.3%) cases were scheduled "fast first and then slowly" steroid-tapering regimen. And of these, 87 (90.6%) cases got irAEs solution.

Conclusions: The "fast first and then slowly" steroid-tapering regimen stayed shorter in the hospital. More studies are needed to confirm this efficacy and find more details about the steroid-tapering regimen.

Keywords: Steroid-tapering regimen; anti-PD-(L)1 therapy; immune-related adverse events.