TY - JOUR
T1 - Association between Smoking and Survival Benefit of Immunotherapy in Advanced Malignancies
T2 - A Systematic Review and Meta-Analysis
AU - Wallis, Christopher J.D.
AU - Satkunasivam, Raj
AU - Butaney, Mohit
AU - Khan, Usman A.
AU - Goldberg, Hanan A.
AU - Freedland, Stephen J.
AU - Patel, Sandip P.
AU - Hamid, Omid
AU - Pal, Sumanta K.
AU - Klaassen, Zachary
N1 - Funding Information:
S.J.F. reported receiving grants from Merck outside of the submitted work. S.P.P. reported receiving scientific advisory income from AstraZeneca, BMS, Illumina, Tempus, and Novartis. S.P.P.’s university receives research funding from Bristol-Myers Squibb, Eli Lilly, Fate, Incyte, AstraZeneca/MedImmune, Merck, Pfizer, Roche/Genentech, Xcovery, Fate Therapeutics, Genocea, and Iovance. S.K.P. reported receiving personal fees from Genentech, Pfizer, and BMS outside of the submitted work. The other authors declare no conflicts of interest.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Objectives:Smoking is associated with an increased tumor mutational burden. As tumor mutational burden has been shown to correlate with response to immunotherapy (IO), we hypothesized that a history of smoking may be associated with better response to IO.Methods:We utilized a systematic review with stratified meta-analysis of randomized clinical trials of IO versus standard of care in patients with advanced solid organ malignancies.Results:Among 9 relevant studies, we found no significant difference in the benefit of IO, compared with other systemic therapies, between ever smokers (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.58-1.04; P=0.09) and never smokers (HR, 0.75; 95% CI, 0.67-0.86; P<0.0001) (test for difference P=0.83). We also observed no significant difference between current (HR, 0.92; 95% CI, 0.63-1.34; P=0.66; I2=67%) and never smokers (HR, 0.74; 95% CI, 0.59-0.93; P=0.01; I2=46%) (test for difference P=0.35).Conclusions:Stratified meta-analysis demonstrates that smoking status is not significantly associated with the response to IO in the treatment of advanced solid organ malignancies.
AB - Objectives:Smoking is associated with an increased tumor mutational burden. As tumor mutational burden has been shown to correlate with response to immunotherapy (IO), we hypothesized that a history of smoking may be associated with better response to IO.Methods:We utilized a systematic review with stratified meta-analysis of randomized clinical trials of IO versus standard of care in patients with advanced solid organ malignancies.Results:Among 9 relevant studies, we found no significant difference in the benefit of IO, compared with other systemic therapies, between ever smokers (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.58-1.04; P=0.09) and never smokers (HR, 0.75; 95% CI, 0.67-0.86; P<0.0001) (test for difference P=0.83). We also observed no significant difference between current (HR, 0.92; 95% CI, 0.63-1.34; P=0.66; I2=67%) and never smokers (HR, 0.74; 95% CI, 0.59-0.93; P=0.01; I2=46%) (test for difference P=0.35).Conclusions:Stratified meta-analysis demonstrates that smoking status is not significantly associated with the response to IO in the treatment of advanced solid organ malignancies.
KW - immunotherapy
KW - smoking
KW - tumor burden
UR - http://www.scopus.com/inward/record.url?scp=85069735263&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85069735263&partnerID=8YFLogxK
U2 - 10.1097/COC.0000000000000577
DO - 10.1097/COC.0000000000000577
M3 - Article
C2 - 31335350
AN - SCOPUS:85069735263
VL - 42
SP - 711
EP - 716
JO - American Journal of Clinical Oncology
JF - American Journal of Clinical Oncology
SN - 0277-3732
IS - 9
ER -