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Real-world outcomes of anti-PD1 antibodies in platinum-refractory, PD-L1-positive recurrent and/or metastatic non-small cell lung cancer, and its potential practical predictors: first report from Korean Cancer Study Group LU19-05.

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Abstract
Abstract
Purpose: Although immune-checkpoint inhibitors have become a new therapeutic option for recurrent/metastatic non-small cell lung cancers (R/M-NSCLC), its clinical benefit in the real-world is still unclear.

Methods: We investigated 1181 Korean patients with programmed death-1 ligand 1 (PD-L1)-positive [tumor proportion score (TPS) ≥ 10% by the SP263 assay or ≥ 50% by the 22C3 assay] R/M-NSCLC treated with pembrolizumab or nivolumab after failure of platinum-based chemotherapy.

Results: The median age was 67 years, 13% of patients had ECOG-PS ≥ 2, and 27% were never-smokers. Adenocarcinoma was predominant (61%) and 18.1% harbored an EGFR activating mutation or ALK rearrangement. Pembrolizumab and nivolumab were administered to 51.3% and 48.7, respectively, and 42% received them beyond the third-line chemotherapy. Objective response rate (ORR) was 28.6%. Pembrolizumab group showed numerically higher ORR (30.7%) than the nivolumab group (26.4%), but it was comparable with that of the nivolumab group having PD-L1 TPS ≥ 50% (32.4%). Median progression-free survival (PFS) and overall survival (OS) were 2.9 (95% CI 0-27.9) and 10.7 months (95% CI 0-28.2), respectively. In multivariable analysis, concordance of TPS ≥ 50% in both PD-L1 assays and the development of immune-related adverse events (irAEs) were two significant predictors of better ORR, PFS, and OS. EGFR mutation could also predict significantly worse OS outcomes.

Conclusion: The real-world benefit of later-line anti-PD1 antibodies was comparable to clinical trials in patients with R/M-NSCLC, although patients generally were more heavily pretreated and had poorer ECOG-PS. Concordantly high PD-L1 TPS ≥ 50% and development of irAE could independently predict better treatment outcomes, while EGFR mutation negatively affected OS.
Author(s)
김상위민영주Byoung-Yong ShimChan-Young OckCheol Hyeon KimGun Lyung YouHee Kyung AhnHyonggin AnIn Jae OhJeong-Seon RyuJi Hyun ParkJin Hyoung KangJin-Soo KimJiun YiJi-Youn HanJong-Seok LeeKi Hyeong LeeMin Hee HongMyung-Ju AhnShin Yup LeeSun Hyo ParkSung Yong LeeYoon Hee Choi
Issued Date
2021
Type
Article
Keyword
BiomarkersImmune-checkpoint inhibitorNon-small cell lung cancerPD-L1Real-worldirAE
DOI
10.1007/s00432-021-03527-4
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8147
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2484153215&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Real-world%20outcomes%20of%20anti-PD1%20antibodies%20in%20platinum-refractory,%20PD-L1-positive%20recurrent%20and%2For%20metastatic%20non-small%20cell%20lung%20cancer,%20and%20its%20potential%20practical%20predictors:%20first%20report%20from%20Korean%20Cancer%20Study%20Group%20LU19-05.&offset=0&pcAvailability=true
Publisher
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
Location
독일
Language
영어
ISSN
0171-5216
Citation Volume
147
Citation Number
8
Citation Start Page
2459
Citation End Page
2469
Appears in Collections:
Medicine > Medicine
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