{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T09:06:05Z","timestamp":1793610365129,"version":"4.5.0"},"reference-count":25,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"28","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2018,10,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Treatment with programmed cell death-1 or programmed death ligand 1 (PD-(L)1) inhibitors is now standard therapy for patients with lung cancer. The immunosuppressive effect of corticosteroids may reduce efficacy of PD-(L)1 blockade. On-treatment corticosteroids for treatment of immune-related adverse events do not seem to affect efficacy, but the potential impact of baseline corticosteroids at the time of treatment initiation is unknown. Clinical trials typically excluded patients who received baseline corticosteroids, which led us to use real-world data to examine the effect of corticosteroids at treatment initiation. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> We identified patients who were PD-(L)1\u2013na\u00efve with advanced non\u2013small-cell lung cancer from two institutions\u2014Memorial Sloan Kettering Cancer Center and Gustave Roussy Cancer Center\u2014who were treated with single-agent PD-(L)1 blockade. Clinical and pharmacy records were reviewed to identify corticosteroid use at the time of beginning anti\u2013PD-(L)1 therapy. We performed multivariable analyses using Cox proportional hazards regression model and logistic regression. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Ninety (14%) of 640 patients treated with single-agent PD-(L)1 blockade received corticosteroids of \u2265 10 mg of prednisone equivalent daily at the start of the PD-(L)1 blockade. Common indications for corticosteroids were dyspnea (33%), fatigue (21%), and brain metastases (19%). In both independent cohorts, Memorial Sloan Kettering Cancer Center (n = 455) and Gustave Roussy Cancer Center (n = 185), baseline corticosteroids were associated with decreased overall response rate, progression-free survival, and overall survival with PD-(L)1 blockade. In a multivariable analysis of the pooled population, adjusting for smoking history, performance status, and history of brain metastases, baseline corticosteroids remained significantly associated with decreased progression-free survival (hazard ratio, 1.3; P = .03), and overall survival (hazard ratio, 1.7; P &lt; .001). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Baseline corticosteroid use of \u2265 10 mg of prednisone equivalent was associated with poorer outcome in patients with non\u2013small-cell lung cancer who were treated with PD-(L)1 blockade. Prudent use of corticosteroids at the time of initiating PD-(L)1 blockade is recommended. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2018.79.0006","type":"journal-article","created":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T20:00:29Z","timestamp":1534795229000},"page":"2872-2878","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":964,"title":["Impact of Baseline Steroids on Efficacy of Programmed Cell Death-1 and Programmed Death-Ligand 1 Blockade in Patients With Non\u2013Small-Cell Lung Cancer"],"prefix":"10.1200","volume":"36","author":[{"given":"Kathryn C.","family":"Arbour","sequence":"first","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mezquita","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niamh","family":"Long","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hira","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edouard","family":"Auclin","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Ni","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gala","family":"Mart\u00ednez-Bernal","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Victoria","family":"Lai","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizza E.L.","family":"Hendriks","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua K.","family":"Sabari","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Caramella","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Plodkowski","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darragh","family":"Halpenny","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie E.","family":"Chaft","sequence":"additional","affiliation":[{"name":"Matthew D. 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Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Weill Cornell Medical College, New York, NY; Laura Mezquita, Roberto Ferrara, Lizza E.L. Hendriks,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"Hellmann","sequence":"additional","affiliation":[{"name":"Matthew D. Hellmann, Parker Institute for Cancer Immunotherapy; Kathryn C. Arbour, Niamh Long, Hira Rizvi, Andy Ni, W. Victoria Lai, Joshua K. Sabari, Andrew J. Plodkowski, Darragh Halpenny, Jamie E. Chaft, Gregory J. Riely, and Matthew D. Hellmann, Memorial Sloan Kettering Cancer Center; Kathryn C. Arbour, W. Victoria Lai, Joshua K. Sabari, Jamie E. 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