Common Lung Cancer Symptom Medication May Reduce Effectiveness of Immunotherapy

Recent research conducted by Keck Medicine of USC highlights the impact of corticosteroids, a frequently prescribed medication to manage symptoms in lung cancer patients, on the success of immunotherapy treatments. Specifically, corticosteroids used to alleviate symptoms such as fatigue, inflammation, or to counter serious side effects like brain swelling and lung inflammation, can hinder the effectiveness of immune checkpoint inhibitors (ICIs), a common form of immunotherapy for non-small cell lung cancer (NSCLC).

The study, published in Cancer Research Communications, found that high doses of steroids administered before or during immunotherapy resulted in less tumor shrinkage and shorter survival times for patients. Dr. Fumito Ito, the lead author, explained that steroids interfere with the body’s ability to fight cancer by preventing T-cells—immune cells responsible for attacking tumors—from fully maturing. This disruption diminishes the immune system’s capacity to target and eliminate cancer cells effectively.

Moreover, the research revealed that steroids decrease levels of circulating biomarkers, which are crucial for oncologists to monitor disease progression and optimize treatment strategies. Without these biomarkers, clinicians may struggle to assess response accurately and adjust therapies appropriately.

To arrive at these conclusions, researchers analyzed medical records from 277 patients with stage II to IV NSCLC treated with ICIs alone or combined with other therapies across three centers, including USC Norris Comprehensive Cancer Center. The study also involved preclinical experiments with mice, which confirmed that steroids inhibit T-cell maturation when administered around the time of immunotherapy.

While the findings suggest caution regarding steroid use during immunotherapy, the researchers acknowledge that steroids remain necessary for managing certain cancer symptoms. The goal is to balance effective symptom control with maximizing treatment efficacy. Dr. Ito emphasizes the importance of understanding the potential limitations of steroids to inform better clinical decisions and improve patient outcomes.

This research paves the way for further studies on how to optimize immunotherapy treatments for lung cancer patients who require steroids, aiming to enhance outcomes while maintaining quality of life.