Clinical StudiesImpact of Baseline Corticosteroids on Immunotherapy Efficacy in Patients With Advanced MelanomaKartolo, Adi*,†; Deluce, Jasna‡,§; Holstead, Ryan*,†; Hopman, Wilma∥; Lenehan, John‡,§; Baetz, Tara*,†Author Information *Cancer Centre of Southeastern Ontario Departments of †Oncology ∥Public Health Sciences, Queen’s University, Kingston ‡London Regional Cancer Program §Department of Oncology, University of Western Ontario, London, ON, Canada Reprints: Tara Baetz, Cancer Care Southeastern Ontario, Queen’s University, 25 King St W, Kingston, ON, Canada K7L 5P9 (e-mail: [email protected]). Journal of Immunotherapy: May 2021 - Volume 44 - Issue 4 - p 167-174 doi: 10.1097/CJI.0000000000000360 Buy Metrics Abstract This is a 2-center, retrospective study which aimed to evaluate the effect of baseline corticosteroid use on immunotherapy efficacy in patients with advanced melanoma. We included all patients with advanced unresectable and metastatic melanoma on single-agent programmed cell death protein 1 (PD-1) inhibitors at the Cancer Centre of Southeastern Ontario and London Regional Cancer Program. We defined baseline corticosteroid use as prednisone-equivalent of ≥10 mg within 30 days of immunotherapy initiation. Our study had 166 patients in total, and 25 were taking corticosteroids at the initiation of the PD-1 inhibitor. Baseline prednisone-equivalent ≥10 mg did not have effect on median overall survival (hazard ratio=1.590, 95% confidence interval: 0.773–3.270, P=0.208). However, a higher dose of baseline prednisone-equivalent ≥50 mg was independently associated with poor median overall survival (hazard ratio=2.313, 95% confidence interval: 1.103–4.830, P=0.026) when compared with baseline prednisone-equivalent 0–49 mg, even when controlled for confounders including baseline Eastern Cooperative Oncology Group ≥2 and baseline brain metastasis. Consideration should be made to decrease the use of unnecessary steroids as much as possible before initiation of PD-1 inhibitor treatment. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.