Real-world survival outcomes with immune checkpoint inhibitors in large-cell neuroendocrine tumors of lung.

BACKGROUND

Little is known regarding the efficacy of immune checkpoint inhibitors (ICI) in patients with advanced large-cell neuroendocrine lung carcinoma (aLCNEC).

METHODS

125 consecutive patients with aLCNEC were identified in the electronic databases of 4 participating cancer centers. The patients were divided into group A (patients who received ICI, n=41) and group B (patients who did not receive ICI, n=84). Overall survival since advanced disease diagnosis (OS DX) and OS since ICI initiation (OS ICI) were captured.

RESULTS

With a median follow-up of 11.8 months (mo) (IQR 7.5-17.9) and 6.0mo (IQR 3.1-10.9), 66% and 76% of patients died in groups A and B, respectively. Median OS DX was 12.4mo (95% CI 10.7 to 23.4) and 6.0mo (95% CI 4.7 to 9.4) in groups A and B, respectively (log-rank test, p=0.02). For ICI administration, HR for OS DX was 0.59 (95% CI 0.38 to 0.93, p=0.02-unadjusted), and 0.58 (95% CI 0.34 to 0.98, p=0.04-adjusted for age, Eastern Cooperative Oncology Group (ECOG) performance status (PS), presence of liver metastases and chemotherapy administration). In a propensity score matching analysis (n=74; 37 patients in each group matched for age and ECOG PS), median OS DX was 12.5 mo (95% CI 10.6 to 25.2) and 8.4 mo (95% CI 5.4 to 16.9) in matched groups A and B, respectively (log-rank test, p=0.046). OS ICI for patients receiving ICI as monotherapy (n=36) was 11.0 mo (95% CI 6.1 to 19.4).

CONCLUSIONS

With the limitations of retrospective design and small sample size, the results of this real-world cohort analysis suggest a positive impact of ICI on OS in aLCNEC.

Informations de copyright

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: ED reported consulting fees from MSD, BMS, Astra Zeneca, Roche, Boehringer Ingelheim, Pfizer, Novartis, Takeda. MM reported consulting fees from Boehringer Ingelheim, Roche, Astra Zeneca, MSD, BMS, Abbvie, Takeda, Pomicell. CK reported research funding (to institution) from AstraZeneca, BMS, Novartis, Regeneron, Tesaro, Karyopharm, Debiopharm, Jassen, and Mirati and consulting fees from Novartis. SVL reported consulting fees from AstraZeneca, Beigene, Blueprint, Boehringer Ingelheim, Bristol-Myers Squibb, Catalyst, Celgene, Clovis, Corvus, G1 Therapeutics, Genentech, Guardant Health, Inivata, Janssen, Jazz, Lilly, LOXO, MSD, PharmaMar, Pfizer, Regeneron, and Takeda and research grants (to institution) from Alkermes, AstraZeneca, Bayer, Blueprint, Bristol-Myers Squibb, Genentech, Lilly, Lycera, Merck, Molecular Partners, Pfizer, Rain Therapeutics, RAPT, Spectrum, and Turning Point Therapeutics. DU reported consulting fees and non-financial support from BMS, Astra Zeneca, Takeda, consulting fees MSD, Roche and Boehringer Ingelheim. AZ reported grants from BMS, personal fees from Roche, MSD, BMS, Astra Zeneca, Takeda. AO reported advisory fees from MSD, BMS, Roche, Astra Zeneca, Novartis, Boehringer Ingelheim. MW reported speaker fees and funding (to institution) from Roche, MSD. JB reported grants and personal fees from MSD, Roche, BMS, Abbvie, Pfizer, Novartis, Astra Zeneca, Boehringer Ingelheim, Takeda.