Impact of baseline medications on real-world overall survival in immune checkpoint inhibitor-treated patients with cancer in the RADIOHEAD cohort.
[BACKGROUND] The benefits of immune checkpoint inhibitors (ICIs) observed in clinical trials often fail to translate to patients with cancer treated in a real-world setting.
- 표본수 (n) 564
- p-value p < 0.001
- 95% CI 1.43-2.24
APA
Stone S, Fadlullah MZ, et al. (2026). Impact of baseline medications on real-world overall survival in immune checkpoint inhibitor-treated patients with cancer in the RADIOHEAD cohort.. Med (New York, N.Y.), 101100. https://doi.org/10.1016/j.medj.2026.101100
MLA
Stone S, et al.. "Impact of baseline medications on real-world overall survival in immune checkpoint inhibitor-treated patients with cancer in the RADIOHEAD cohort.." Med (New York, N.Y.), 2026, pp. 101100.
PMID
41999755
Abstract
[BACKGROUND] The benefits of immune checkpoint inhibitors (ICIs) observed in clinical trials often fail to translate to patients with cancer treated in a real-world setting. The identification of modifiable or monitorable exposures, such as baseline medication status, that may influence patient outcomes is necessary to reconcile disparities between clinical trial and real-world ICI efficacy.
[METHODS] We analyzed baseline medication use obtained through electronic data capture (EDC) from the real-world RADIOHEAD cohort, a prospective, pan-cancer collection of immunotherapy-naive patients receiving standard-of-care ICI treatment across the United States. Survival analyses were performed to evaluate associations between both individual and cumulative medication exposures and real-world overall survival (rwOS).
[FINDINGS] Of 1,024 patients from the RADIOHEAD cohort, 55% (n = 564/1,024) were exposed to polypharmacy, defined as more than five drug classes, at ICI initiation. Polypharmacy, explored as a continuous variable of cumulative medication exposure, was significantly associated with worse rwOS (hazard ratio [HR] 1.06 [95% confidence interval [CI] 1.03-1.10], p < 0.001, q = 0.005). Among individual medication class exposures, there was a strong association between opioids and worse rwOS (HR 1.79 [95% CI 1.43-2.24], p < 0.001), as well as beta-blocker use (HR 1.38 [95% CI, 1.10-1.72], p = 0.005), after adjusting for clinically relevant covariates and patterns of co-prescription. The association between opioid exposure and worse rwOS was independent of additional palliative medication use (HR 1.61 [95% CI 1.09-2.36], p = 0.016, p for interaction = 0.4) and persisted in patients with early-stage and non-metastatic disease (p = 0.044).
[CONCLUSIONS] Polypharmacy and baseline medication exposures, particularly opioid and beta-blocker use, have prognostic significance for rwOS in patients with cancer receiving ICI treatment. This study evaluates the influence of baseline medications on ICI efficacy within the context of cumulative medication exposures reflective of co-prescription.
[FUNDING] This study was supported in part by the National Institutes of Health and the Parker Institute for Cancer Immunotherapy (PICI).
[METHODS] We analyzed baseline medication use obtained through electronic data capture (EDC) from the real-world RADIOHEAD cohort, a prospective, pan-cancer collection of immunotherapy-naive patients receiving standard-of-care ICI treatment across the United States. Survival analyses were performed to evaluate associations between both individual and cumulative medication exposures and real-world overall survival (rwOS).
[FINDINGS] Of 1,024 patients from the RADIOHEAD cohort, 55% (n = 564/1,024) were exposed to polypharmacy, defined as more than five drug classes, at ICI initiation. Polypharmacy, explored as a continuous variable of cumulative medication exposure, was significantly associated with worse rwOS (hazard ratio [HR] 1.06 [95% confidence interval [CI] 1.03-1.10], p < 0.001, q = 0.005). Among individual medication class exposures, there was a strong association between opioids and worse rwOS (HR 1.79 [95% CI 1.43-2.24], p < 0.001), as well as beta-blocker use (HR 1.38 [95% CI, 1.10-1.72], p = 0.005), after adjusting for clinically relevant covariates and patterns of co-prescription. The association between opioid exposure and worse rwOS was independent of additional palliative medication use (HR 1.61 [95% CI 1.09-2.36], p = 0.016, p for interaction = 0.4) and persisted in patients with early-stage and non-metastatic disease (p = 0.044).
[CONCLUSIONS] Polypharmacy and baseline medication exposures, particularly opioid and beta-blocker use, have prognostic significance for rwOS in patients with cancer receiving ICI treatment. This study evaluates the influence of baseline medications on ICI efficacy within the context of cumulative medication exposures reflective of co-prescription.
[FUNDING] This study was supported in part by the National Institutes of Health and the Parker Institute for Cancer Immunotherapy (PICI).