Association between Smoking and Survival Benefit of Immunotherapy in Advanced Malignancies

A Systematic Review and Meta-Analysis

Christopher J.D. Wallis, Raj Satkunasivam, Mohit Butaney, Usman A. Khan, Hanan A. Goldberg, Stephen J. Freedland, Sandip P. Patel, Omid Hamid, Sumanta K. Pal, Zachary W A Klaassen

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)711-716
Number of pages6
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume42
Issue number9
DOIs
StatePublished - Sep 1 2019

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Immunotherapy
Meta-Analysis
Smoking
Survival
Confidence Intervals
Neoplasms
Tumor Burden
Standard of Care
Randomized Controlled Trials
Therapeutics

Keywords

  • immunotherapy
  • smoking
  • tumor burden

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Association between Smoking and Survival Benefit of Immunotherapy in Advanced Malignancies : A Systematic Review and Meta-Analysis. / Wallis, Christopher J.D.; Satkunasivam, Raj; Butaney, Mohit; Khan, Usman A.; Goldberg, Hanan A.; Freedland, Stephen J.; Patel, Sandip P.; Hamid, Omid; Pal, Sumanta K.; Klaassen, Zachary W A.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 42, No. 9, 01.09.2019, p. 711-716.

Research output: Contribution to journalArticle

Wallis, Christopher J.D. ; Satkunasivam, Raj ; Butaney, Mohit ; Khan, Usman A. ; Goldberg, Hanan A. ; Freedland, Stephen J. ; Patel, Sandip P. ; Hamid, Omid ; Pal, Sumanta K. ; Klaassen, Zachary W A. / Association between Smoking and Survival Benefit of Immunotherapy in Advanced Malignancies : A Systematic Review and Meta-Analysis. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2019 ; Vol. 42, No. 9. pp. 711-716.
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AU - Khan, Usman A.

AU - Goldberg, Hanan A.

AU - Freedland, Stephen J.

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