Portal de investigación
The efficacy and safety of immune checkpoint inhibitors combined with chemotherapy or anti-angiogenic therapy as a second-line or later treatment option for advanced non-small cell lung cancer: a retrospective comparative cohort study
Fecha de publicación:
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Autores organización
Autores
- Chen B
- Wang J
- Pu X
- Li J
- Wang Q
- Liu L
- Xu Y
- Xu L
- Kong Y
- Li K
- Xu F
- Liang S
- Wu L
Grupos de investigación
Resumen
Background: Although immune checkpoint inhibitor (ICI) monotherapy remains the standard of second-line treatment for patients with advanced non-small cell lung cancer (NSCLC) , the objective response rate (ORR) is low. There is an urgent need to increase the response population of second-line immunotherapy, and ICI combination therapy may be a possible option. However, the evidence is insufficient. Methods: We retrospectively collected the medical records of patients who received ICI monotherapy or ICI combination therapy as a second-line or later treatment option. We further analysed baseline clinical characteristics, evaluated treatment efficacy, assessed treatment-related adverse events (AEs) and followed up survival. The outcome variables assessed in the study were ORR, disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and AEs. Results: A total of 145 patients were ultimately enrolled in this study, including the ICI monotherapy group (n=63) and ICI combination therapy group (n=82). The ICI combination therapy group was further divided into the ICI/chemotherapy group (n=57) and ICI/anti-angiogenic therapy group (n=25). The baseline was comparable among the three subgroups. The ICI combination therapy groups showed a higher ORR (29.3% vs. 11.1%, P=0.008) and DCR (85.4% vs. 61.9%, P=0.001) and a longer PFS (6.77 vs. 3.47 months, P<0.001) and OS (18.60 vs. 8.47 months, P<0.001) than the ICI monotherapy group. The ICI/chemotherapy group showed a significantly higher ORR (31.6% vs. 11.1%, P=0.006) and DCR (84.2% vs. 61.9%, P=0.006) and a longer PFS (6.37 vs. 3.47 months, P<0.001) and OS (18.60 vs. 8.47 months, P<0.001) than the ICI monotherapy group. The ICI/anti-angiogenic therapy group showed a significantly higher DCR (88.0% vs. 61.9%, P=0.021) and a longer PFS (8.17 vs. 3.47 months, P<0.001) and OS (19.20 vs. 8.47 months, P=0.005) than the ICI monotherapy group. Neither of the combined ICI therapy groups showed a significant increase in the incidence of AEs compared to the ICI monotherapy group. Conclusions: ICI combined with chemotherapy or anti-angiogenic therapy as second-line or later treatment demonstrated superiority over ICI monotherapy in advanced NSCLC patients without prior immunotherapy. These results provide a potentially superior treatment strategy and require verification in prospective clinical trials. © 2022 AME Publishing Company. All rights reserved.
2022 Translational Lung Cancer Research. All rights reserved.
Datos de la publicación
- ISSN/ISSNe:
- 2218-6751, 2226-4477
- Tipo:
- Article
- Páginas:
- 2111-2124
- DOI:
- 10.21037/tlcr-22-697
- PubMed:
- 36386462
- Enlace a otro recurso:
- www.scopus.com
Translational Lung Cancer Research AME Publishing Company
Citas Recibidas en Web of Science: 2
Citas Recibidas en Scopus: 11
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Keywords
- alanine aminotransferase; amylase; angiogenesis inhibitor; antineoplastic agent; antineoplastic metal complex; aspartate aminotransferase; bevacizumab; camrelizumab; catequentinib; docetaxel; gemcitabine; immune checkpoint inhibitor; nivolumab; paclitaxel; pembrolizumab; pemetrexed; programmed death 1 ligand 1; sintilimab; toripalimab; triacylglycerol lipase; adult; advanced cancer; aged; anemia; antiangiogenic therapy; Article; cancer chemotherapy; cancer patient; cancer survival; clinical feature; cohort analysis; comparative study; disease control; drug efficacy; drug safety; female; follow up; human; hyperthyroidism; hypopituitarism; hypothyroidism; incidence; leukopenia; major clinical study; male; median survival time; monotherapy; myocarditis; nausea; neutropenia; non small cell lung cancer; outcome assessment; outcome variable; overall response rate; overall survival; pneumonia; progression free survival; prospective study; rash; retrospective study; side effect; thrombocytopen