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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Cancer Immunity and Immunotherapy
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1459608

Association between smoking status, toxicity and survival in the checkpoint inhibitor immunotherapy

Provisionally accepted
Anna Rudzińska Anna Rudzińska 1*Pola Juchaniuk Pola Juchaniuk 1Jakub Oberda Jakub Oberda 1Kamila Krukowska Kamila Krukowska 1Sylwia Krzyśkowska Sylwia Krzyśkowska 1Eliza Kuchta Eliza Kuchta 1Anna Rodzajewska Anna Rodzajewska 1Mariola Janiszewska Mariola Janiszewska 2*Katarzyna Szklener Katarzyna Szklener 1Katarzyna Machulska- Ciuraj Katarzyna Machulska- Ciuraj 1Monika Rychlik-Grabowska Monika Rychlik-Grabowska 1Aleksandra Urniaż Aleksandra Urniaż 3Rafał Urniaż Rafał Urniaż 3*Sławomir Mańdziuk Sławomir Mańdziuk 1
  • 1 Department of Clinical Oncology and Chemotherapy, Medical University of Lublin, Lublin Poland, Lublin, Poland
  • 2 Department of Medical Informatics and Statistics with the e-Health Laboratory, Medical University of Lublin, Lublin, Lublin, Poland
  • 3 Other, 63-66 Hatton Garden, London, United Kingdom

The final, formatted version of the article will be published soon.

    Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy by enhancing T-cellmediated immune responses against tumors. However, their use can lead to immune-related adverse events (irAEs), impacting patient outcomes. This single-center, observational study investigates the relationship between immune-related adverse events (irAEs) and survival outcomes in 151 patients treated with ICIs, with or without chemotherapy, at the Department of Clinical Oncology and Chemotherapy in the Independent Public Hospital No. 4 in Lublin. Statistical analyses were performed using the log-rank test, and multivariable Cox proportional hazard model (p < 0.05). IrAEs were observed in 38% of patients, with the most common being thyroid dysfunction (11.9%) and dermal toxicity (6.6%). Individual toxicity groups presented similar median values of "pack-years", suggesting that smoking did not have a direct impact on the degree of toxicity. No relationship between the number of "pack-years" and the time of occurrence of toxicity symptoms and the number of toxicity sites was found. Smoking status did not have a moderating effect on the toxicity parameter in survival analysis (OS) and progression free survival analysis (PFS). Pack-years of smoking significantly impacted both OS (HR = 1.01, p = 0.014) and PFS (HR = 1.01, p = 0.011). The results suggested that smoking, measured in pack-years, had no appreciable effect on the amount of toxicity experienced by patients and no correlation between smoking status, irAEs and efficiency of the treatment was found. Despite results not reaching statistical significance, other potential mechanisms by which smoking may influence cancer treatment cannot be ruled out.

    Keywords: cancer immunotherapy, Immunotherapy toxicity, immune checkpoint inhibitors, immunotherapy adverse effects, Smoking

    Received: 04 Jul 2024; Accepted: 05 Nov 2024.

    Copyright: © 2024 Rudzińska, Juchaniuk, Oberda, Krukowska, Krzyśkowska, Kuchta, Rodzajewska, Janiszewska, Szklener, Machulska- Ciuraj, Rychlik-Grabowska, Urniaż, Urniaż and Mańdziuk. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Anna Rudzińska, Department of Clinical Oncology and Chemotherapy, Medical University of Lublin, Lublin Poland, Lublin, Poland
    Mariola Janiszewska, Department of Medical Informatics and Statistics with the e-Health Laboratory, Medical University of Lublin, Lublin, 20-090, Lublin, Poland
    Rafał Urniaż, Other, 63-66 Hatton Garden, London, United Kingdom

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