Herpes zoster in patients with lung cancer treated with PD-1/PD-L1 antibodies

Immunotherapy. 2022 Oct;14(15):1211-1217. doi: 10.2217/imt-2021-0318. Epub 2022 Aug 30.

Abstract

Background: There are no available clinical data on immunotherapy and the risk of herpes zoster. Materials & methods: This retrospective study included patients with recurrent or advanced lung cancer who were inoperable and ineligible for radiotherapy and were treated with either a PD-1/PD-L1 antibody (136 patients) or an EGFR tyrosine kinase inhibitor (149 patients) at Jichi Medical University Hospital between January 2016 and December 2018. Results: Herpes zoster-free survival was significantly shorter in the PD-1/PD-L1 antibody-treated group compared with the EGFR tyrosine kinase inhibitor-treated group (hazard ratio: 0.20; 95% CI: 0.048-0.84; p = 0.016). PD-1/PD-L1 antibody administration was independently and significantly associated with herpes zoster occurrence. Conclusion: Clinicians should anticipate herpes zoster in patients with lung cancer during treatment with PD-1/PD-L1 antibodies.

Keywords: EGFR tyrosine kinase inhibitor; PD-1; PD-L1; herpes zoster; lung cancer.

Plain language summary

There are no available clinical data on immunotherapy and the risk of herpes zoster. This retrospective study included patients with recurrent or advanced lung cancer who were inoperable and ineligible for radiotherapy and were treated with either an immune checkpoint inhibitor (136 patients) or an EGFR tyrosine kinase inhibitor (149 patients) through the authors' university between January 2016 and December 2018. The herpes zoster-free period was significantly shorter in the immune checkpoint inhibitor-treated group compared with the EGFR tyrosine kinase inhibitor-treated group (hazard ratio: 0.20; 95% CI: 0.048–0.84; p = 0.016). Immune checkpoint inhibitor antibody administration was independently and significantly associated with herpes zoster occurrence. Clinicians should be cautious of herpes zoster in patients with lung cancer during treatment with immune checkpoint inhibitors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • B7-H1 Antigen
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • ErbB Receptors
  • Herpes Zoster* / epidemiology
  • Humans
  • Lung Neoplasms* / drug therapy
  • Programmed Cell Death 1 Receptor
  • Protein Kinase Inhibitors / therapeutic use
  • Retrospective Studies

Substances

  • B7-H1 Antigen
  • Programmed Cell Death 1 Receptor
  • Protein Kinase Inhibitors
  • ErbB Receptors