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Steroids ICI Efficacy — SCE Medical Oncology MCQ

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ModerateLung CancerSteroids ICI EfficacySCE Medical Oncology

A 70-year-old man with NSCLC on pembrolizumab develops new autoimmune haemolytic anaemia. Prednisolone 1mg/kg started. What concern about prolonged high-dose steroids during ICI?

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Correct answer: B — Prolonged steroids (>10mg prednisolone for >2-4 weeks) may reduce ICI efficacy by suppressing T-cell function; taper to ≤10mg as quickly as irAE control allows

Steroids for irAE: adequate dose to control irAE, but taper to ≤10mg prednisolone ASAP. Steroids for irAE management do NOT appear to negate ICI benefit in most analyses (irAE itself is positive marker).

Reference: Ricciuti et al JCO 2019; ESMO 2024 irAE