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Master Thesis

Étude rétrospective de l’incidence des effets indésirables induits par l’immunothérapie et de leurs conséquences sur la survie des patients atteints d’un cancer bronchique ou d’un mésothéliome

Abstract : Introduction: In lung cancer treatment, the development of immunotherapy has allowed therapeutic progress. Toxicities are different than chemotherapy. The objective was to evaluate adverse effects of immunotherapy and to study the relationship between the number of toxicities and patients survival. Methods: This retrospective, observational study collected data from patients with non-small cell lung cancer (NSCLC) or mesothelioma treated by immunotherapy between January 2017 and June 2018 at the University Hospital of Caen. Results: 99 patients were included, 90 with NSCLC and 9 with mesothelioma. 71 patients received nivolumab, 22 pembrolizumab, 6 nivolumab-ipilimumab. 82.8% experienced an adverse event. It was grade III / IV in 17% of cases. The main toxicities are dermatological (pruritus, erythema) endocrine (dysthyroidism), rheumatologic (arthralgia, inflammatory rheumatism), digestive (hepatitis, colitis), respiratory (interstitial pneumonitis). The median progression-free survival is not reached for patients with more than 4 toxicities compared to 2 months in the absence of toxicity (p <0.001). In patients receiving at least 6 weeks of treatment, it was not reached in the “more than 4 toxicities” group against 2.5 months in the “absence of toxicity” group (p <0.001). The observation is similar in patients treated with nivolumab or pembrolizumab. Conclusion: The adverse effects on immunotherapy are mainly immunological. Patients with the most toxicities of immunotherapy appear to have better progression-free survival.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02469507
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Sylvain Teulier. Étude rétrospective de l’incidence des effets indésirables induits par l’immunothérapie et de leurs conséquences sur la survie des patients atteints d’un cancer bronchique ou d’un mésothéliome. Médecine humaine et pathologie. 2019. ⟨dumas-02469507⟩

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