Safety and efficacy of pembrolizumab for advanced nonsmall cell lung cancer: before and during the COVID-19 pandemic.
COVID-19
Lung cancer
Pembrolizumab
Safety
Toxicity
Journal
Journal of cancer research and clinical oncology
ISSN: 1432-1335
Titre abrégé: J Cancer Res Clin Oncol
Pays: Germany
ID NLM: 7902060
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
30
04
2022
accepted:
28
06
2022
medline:
5
7
2023
pubmed:
15
7
2022
entrez:
14
7
2022
Statut:
ppublish
Résumé
The COVID-19 pandemic changed diagnostic and treatment pathways in oncology. We compared the safety and efficacy of pembrolizumab amongst advanced nonsmall cell lung cancer (NSCLC) patients with a PD-L1 tumor proportion score (TPS) ≥ 50% before and during the pandemic. Advanced NSCLC patients initiating pembrolizumab between June 2015 and December 2019 ("pre-pandemic cohort") and between March 2020 and March 2021 ("pandemic cohort") at BC Cancer were identified retrospectively. Multivariable logistic regression evaluated risk factors for immune-related adverse events (irAE) ≥ grade 3 at the 6 week, 3 month, and 6 month landmarks. Cox regression models of overall survival (OS) were constructed. The study population comprised 417 patients in the pre-pandemic cohort and 111 patients in the pandemic cohort. Between March and May 2020, 48% fewer advanced NSCLC cases with PD-L1 TPS ≥ 50% were diagnosed compared to similar intervals in 2018-2019. Telemedicine assessment [new patient consultations (p < 0.001) and follow-up (p < 0.001)] and extended interval pembrolizumab dosing (p < 0.001) were more common in the pandemic cohort. Patients initiating pembrolizumab after February 2020 (vs. before January 2020) experienced similar odds of developing severe irAE. 2/111 (1.8%) patients receiving pembrolizumab during the pandemic tested positive for COVID-19. On multivariable analysis, no association between pembrolizumab treatment period (before vs. during the COVID-19 pandemic) and OS was observed (p = 0.18). Significant changes in healthcare delivery in response to the pandemic did not result in increased high grade toxicity or lower survival outcomes in patients with advanced NSCLC treated with pembrolizumab.
Identifiants
pubmed: 35834010
doi: 10.1007/s00432-022-04181-0
pii: 10.1007/s00432-022-04181-0
pmc: PMC9281358
doi:
Substances chimiques
pembrolizumab
DPT0O3T46P
B7-H1 Antigen
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2951-2961Subventions
Organisme : BC Cancer Foundation
ID : F21-02290
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Aragon TJ (2020). Epitools: epidemiology tools. R package version 0.5-10.1. https://CRAN.R-project.org/package=epitools . Accessed 1 March 2022
BC Cancer (2020) Provincial cancer clinical management guidelines in pandemic situation (COVID-19). BC Cancer. http://www.bccancer.bc.ca/health-professionals-site/Documents/Provincial%20Cancer%20Therapy%20Clinical%20Management%20Guidelines%20in%20Pandemic%20situation%20%28COVID-19%29_April%2014%202020UPDATED.pdf . Accessed 5 January 2022.
Bhalla S, Bakouny Z, Schmidt AL et al (2021) Care disruptions among patients with lung cancer: a COVID-19 and cancer outcomes study. Lung Cancer 160:78–83. https://doi.org/10.1016/j.lungcan.2021.07.002
doi: 10.1016/j.lungcan.2021.07.002
pubmed: 34461400
Curigliano G, Banerjee S, Cervantes A et al (2020) Managing cancer patients during the COVID-19 pandemic: an ESMO multidisciplinary expert consensus. Ann Oncol 31:1320–1335. https://doi.org/10.1016/j.annonc.2020.07.010
doi: 10.1016/j.annonc.2020.07.010
pubmed: 32745693
Elkaddoum R, Haddad FG, Eid R, Kourie HR (2020) Telemedicine for cancer patients during COVID-19 pandemic: between threats and opportunities. Future Oncol 16:1225–1227. https://doi.org/10.2217/fon-2020-0324
doi: 10.2217/fon-2020-0324
pubmed: 32356460
Elkrief A, Kazandjian S, Bouganim N (2020) Changes in lung cancer treatment as a result of the coronavirus disease 2019 pandemic. JAMA Oncol 6:1805–1806. https://doi.org/10.1001/jamaoncol.2020.4408
doi: 10.1001/jamaoncol.2020.4408
pubmed: 32940638
pmcid: 7499239
Ellis S, Vierra AT, Millsop JW et al (2020) Dermatologic toxicities to immune checkpoint inhibitor therapy: a review of histopathologic features. J Am Acad Dermatol 83:1130–1143. https://doi.org/10.1016/j.jaad.2020.04.105
doi: 10.1016/j.jaad.2020.04.105
pubmed: 32360716
pmcid: 7492441
Garassino MC, Whisenant JG, Huang L-C et al (2020) COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study. Lancet Oncol 21:914–922. https://doi.org/10.1016/S1470-2045(20)30314-4
doi: 10.1016/S1470-2045(20)30314-4
pubmed: 32539942
pmcid: 7292610
Gourd E (2020) Lung cancer control in the UK hit badly by COVID-19 pandemic. Lancet Oncol 21:1559. https://doi.org/10.1016/S1470-2045(20)30691-4
doi: 10.1016/S1470-2045(20)30691-4
pubmed: 33189158
pmcid: 7832558
Government of Canada (2022) Interactive data visualizations of COVID-19. https://health-infobase.canada.ca/covid-19/?stat=num&measure=total&map=pt#a2 . Accessed 5 April 2022
Hsiehchen D, Watters MK, Lu R et al (2019) Variation in the assessment of immune-related adverse event occurrence, grade, and timing in patients receiving immune checkpoint inhibitors. JAMA Netw Open 2:e1911519. https://doi.org/10.1001/jamanetworkopen.2019.11519
doi: 10.1001/jamanetworkopen.2019.11519
pubmed: 31532516
pmcid: 6751757
Kasymjanova G, Anwar A, Cohen V et al (2021) The impact of COVID-19 on the diagnosis and treatment of lung cancer at a Canadian Academic Center: a retrospective chart review. Curr Oncol 28:4247–4255. https://doi.org/10.3390/curroncol28060360
doi: 10.3390/curroncol28060360
pubmed: 34898542
pmcid: 8544580
Ksienski D, Wai ES, Alex D, et al (2021) Prognostic significance of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for advanced non-small cell lung cancer patients with high PD-L1 tumor expression receiving pembrolizumab. Transl Lung Cancer Res 10:355–367. https://doi.org/10.21037/tlcr-20-541
Middleton G, Brock K, Savage J et al (2020) Pembrolizumab in patients with non-small-cell lung cancer of performance status 2 (PePS2): a single arm, phase 2 trial. Lancet Respir Med 8:895–904. https://doi.org/10.1016/S2213-2600(20)30033-3
doi: 10.1016/S2213-2600(20)30033-3
pubmed: 32199466
Pan American Health Organization (2016) Framework for the implementation of a telemedicine service. Accessed 16 January 2022
Passaro A, Bestvina C, Velez Velez M et al (2021) Severity of COVID-19 in patients with lung cancer: evidence and challenges. J Immunother Cancer 9:e002266. https://doi.org/10.1136/jitc-2020-002266
doi: 10.1136/jitc-2020-002266
pubmed: 33737345
pmcid: 7978268
R Core Team (2021) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/ . Accessed 15 March 2022
Reck M, Rodríguez-Abreu D, Robinson AG et al (2016) Pembrolizumab versus chemotherapy for PD-L1-positive non-small-cell lung cancer. N Engl J Med 375:1823–1833. https://doi.org/10.1056/NEJMoa1606774
doi: 10.1056/NEJMoa1606774
pubmed: 27718847
Reyes R, López-Castro R, Auclin E, et al (2021) MA03.08 Impact of COVID-19 pandemic in the diagnosis and prognosis of lung cancer. J Thorac Oncol 16:S141. https://doi.org/10.1016/j.jtho.2021.01.219
Sehgal K, Gill RR, Widick P et al (2021) Association of performance status with survival in patients with advanced non-small cell lung cancer treated with pembrolizumab monotherapy. JAMA Netw Open 4:e2037120. https://doi.org/10.1001/jamanetworkopen.2020.37120
doi: 10.1001/jamanetworkopen.2020.37120
pubmed: 33570575
pmcid: 7879233
U.S. Department of Health and Human Services (2017) Common terminology criteria for adverse events (CTCAE) version 5.0 Accessed 15 October 2021