Immune-Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer With Uncommon Histology.

Adult Aged Aged, 80 and over Carcinoma, Non-Small-Cell Lung / drug therapy Female Humans Immune Checkpoint Inhibitors / pharmacology Kaplan-Meier Estimate Lung Neoplasms / drug therapy Male Middle Aged Proportional Hazards Models Retrospective Studies Survival Analysis

ICIs Immunotherapy Lung cancer Rare histology Uncommon NSCLC

Journal

Clinical lung cancer

ISSN: 1938-0690

Titre abrégé: Clin Lung Cancer

Pays: United States

ID NLM: 100893225

Informations de publication

Date de publication:
01 2022

Historique:

received: 21 04 2021

revised: 17 06 2021

accepted: 24 06 2021

pubmed: 3 8 2021

medline: 9 3 2022

entrez: 2 8 2021

Statut: ppublish

Résumé

Immune-checkpoint inhibitors (ICIs) have significantly improved outcome of advanced non-small cell lung cancer (aNSCLC) patients. However, their efficacy remains uncertain in uncommon histologies (UH). Data from ICI treated aNSCLC patients (April,2013-January,2021) in one Institution were retrospectively collected. Univariate and multivariate survival analyses were estimated by Kaplan-Meier and Cox proportional hazards regression model, respectively. Objective response rate (ORR) and disease control rate (DCR) were assessed. Of 375 patients, 79 (21.1%) had UH: 19 (24.1%) sarcomatoid carcinoma, 15 (19.0%) mucinous adenocarcinoma, 10 (12.6%) enteric adenocarcinoma, 8 (10.1%) adenocarcinoma not otherwise specified, 7 (8.9%) large-cell neuroendocrine carcinoma, 6 (7.6%) mixed histology non-adenosquamous, 5 (6.3%) adenosquamous carcinoma, 9 (11.4%) other UH. In UH group, programmed death-ligand 1 (PD-L1) <1%, 1-49%, ≥50% and unknown expression were reported in 27.8%, 22.8%, 31.7% and 17.7% patients respectively and ICI was the second/further-line in the majority of patients. After a median follow-up of 35.64 months (m), median progression-free survival (mPFS) was 2.5 m in UH [95% CI 2.2-2.9 m] versus (vs.) 2.7 m in CH [95% CI 2.3-3.2 m, P-value = .584]; median overall survival (mOS) was 8.8 m [95% CI 4.9-12.6 m] vs. 9.7 m [95% CI 8.0-11.3 m, P-value = .653]. At multivariate analyses only ECOG PS was a confirmed prognostic factor in UH. ORR and DCR were 25.3% and 40.5% in UH vs. 21.6% and 49.5% in CH [P-value = .493 and .155 respectively]. No significant differences were detected between UH and CH groups. Prospective trials are needed to understand ICIs role in UH population.

Sections du résumé

BACKGROUND

MATERIALS AND METHODS

Data from ICI treated aNSCLC patients (April,2013-January,2021) in one Institution were retrospectively collected. Univariate and multivariate survival analyses were estimated by Kaplan-Meier and Cox proportional hazards regression model, respectively. Objective response rate (ORR) and disease control rate (DCR) were assessed.

RESULTS

Of 375 patients, 79 (21.1%) had UH: 19 (24.1%) sarcomatoid carcinoma, 15 (19.0%) mucinous adenocarcinoma, 10 (12.6%) enteric adenocarcinoma, 8 (10.1%) adenocarcinoma not otherwise specified, 7 (8.9%) large-cell neuroendocrine carcinoma, 6 (7.6%) mixed histology non-adenosquamous, 5 (6.3%) adenosquamous carcinoma, 9 (11.4%) other UH. In UH group, programmed death-ligand 1 (PD-L1) <1%, 1-49%, ≥50% and unknown expression were reported in 27.8%, 22.8%, 31.7% and 17.7% patients respectively and ICI was the second/further-line in the majority of patients. After a median follow-up of 35.64 months (m), median progression-free survival (mPFS) was 2.5 m in UH [95% CI 2.2-2.9 m] versus (vs.) 2.7 m in CH [95% CI 2.3-3.2 m, P-value = .584]; median overall survival (mOS) was 8.8 m [95% CI 4.9-12.6 m] vs. 9.7 m [95% CI 8.0-11.3 m, P-value = .653]. At multivariate analyses only ECOG PS was a confirmed prognostic factor in UH. ORR and DCR were 25.3% and 40.5% in UH vs. 21.6% and 49.5% in CH [P-value = .493 and .155 respectively].

CONCLUSIONS

No significant differences were detected between UH and CH groups. Prospective trials are needed to understand ICIs role in UH population.

Identifiants

DOI: 10.1016/j.cllc.2021.06.013 PMID: 34334296

pubmed: 34334296

pii: S1525-7304(21)00180-7

doi: 10.1016/j.cllc.2021.06.013

pii:

doi:

Substances chimiques

Immune Checkpoint Inhibitors 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

e17-e28