Retrospective cohort study of survival impact of systemic glucocorticoid immunosuppression among immune checkpoint inhibitor recipients

Systemic glucocorticoid immunosuppression (gsISP) is commonly used among patients receiving immune checkpoint inhibitor (ICI) therapy. A retrospective cohort study examined associations of gsISP timing, dose, and duration with overall survival (OS) among ICI recipients. The study included ICI recipients at Massachusetts General Hospital, Brigham and Women’s Hospital, and Dana-Farber Cancer Institute (all in Boston, MA; MGBD cohort) from 2015 through 2021 and matched ICI recipients from the TriNetX database from 2010 through 2021 for independent validation. In this cohort study of 39 258 ICI recipients, there was a decrease in survival probability as gsISP was administered closer to the initiation of ICI therapy, as well as with higher dose and longer duration of gsISP. The authors conclude that when gsISP is necessary for patients receiving ICIs, clinicians should carefully consider timing, dose, and duration.