Portal de investigación
Immunotherapy at any line of treatment improves survival in patients with advanced metastatic non-small cell lung cancer (NSCLC) compared with chemotherapy (Quijote-CLICaP)
Fecha de publicación:
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Autores organización
Autores
- Ruiz-Patiño A.
- Arrieta O.
- Martín C.
- Raez L.E.
- Zatarain-Barrón Z.L.
- Barrón F.
- Ricaurte L.
- Bravo-Garzón M.A.
- Mas L.
- Corrales L.
- Lupinacci L.
- Perazzo F.
- Bas C.
- Carranza O.
- Puparelli C.
- Rizzo M.
- Ruiz R.
- Rolfo C.
- Archila P.
- Rodríguez J.
- Sotelo C.
- Vargas C.
- Carranza H.
- Otero J.
- Pino L.E.
- Ortíz C.
- Laguado P.
- Rosell R.
Grupos de investigación
Resumen
Background: To compare survival outcomes of patients with advanced or metastatic non-small cell lung cancer (NSCLC) who received immunotherapy as first-, second- or beyond line, versus matched patients receiving standard chemotherapy with special characterization of hyperprogressors. Methods: A retrospective cohort study of 296 patients with unresectable/metastatic NSCLC treated with either, first-, second-, third- or fourth-line of immunotherapy was conducted. A matched comparison with a historical cohort of first-line chemotherapy and a random forest tree analysis to characterize hyperprogressors was conducted. Results: Median age was 64 years (range 34–90), 40.2% of patients were female. A total of 91.2% of patients had an Eastern Cooperative Oncology Group (ECOG) performance score = 1. Immunotherapy as first-line was given to 39 patients (13.7%), second-line to 140 (48.8%), and as third-line and beyond to 108 (37.6%). Median overall survival was 12.7 months (95% CI 9.67–14 months) and progression-free survival (PFS) of 4.27 months (95% CI 3.97–5.0). Factors associated with increased survival included treatment with immunotherapy as first-line (P < 0.001), type of response (P < 0.001) and PD-L1 status (P = 0.0039). Compared with the historical cohort, immunotherapy proved to be superior in terms of OS (P = 0.05) but not PFS (P = 0.2). A total of 44 hyperprogressors were documented (19.8%, [95% CI 14.5–25.1%]). Leukocyte count over 5.300 cells/dL was present in both hyperprogressors and long-term responders. Conclusions: Patients who receive immune-checkpoint inhibitors as part of their treatment for NSCLC have better overall survival (OS) compared with matched patients treated with standard chemotherapy, regardless of the line of treatment. © 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd
Datos de la publicación
- ISSN/ISSNe:
- 1759-7706, 1759-7714
- Tipo:
- Article
- Páginas:
- 353-361
- PubMed:
- 31828967
- Enlace a otro recurso:
- www.scopus.com
Thoracic Cancer John Wiley and Sons Inc
Citas Recibidas en Web of Science: 32
Citas Recibidas en Scopus: 41
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Keywords
- Adult; Aged; Aged, 80 and over; Antineoplastic Agents, Immunological; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Non-Small-Cell Lung; Carcinoma, Squamous Cell; Female; Follow-Up Studies; Humans; Immunotherapy; Lung Neoplasms; Male; Middle Aged; Prognosis; Retrospective Studies; Survival Rate; atezolizumab; avelumab; carboplatin; docetaxel; durvalumab; entinostat; ipilimumab; nivolumab; pembrolizumab; pemetrexed; programmed death 1 ligand 1; antineoplastic agent; immunological antineoplastic agent; adult; aged; Article; body weight loss; bone metastasis; cancer chemotherapy; cancer fatigue; cancer immunotherapy; cancer staging; cancer survival; central nervous system metastasis; cohort analysis; drug safety; female; Hispanic; human; human tissue; hypophysitis; hypothyroidism; leukocyte count; lung metastasis; major clinical study; male; nephritis; non profit organization; non small cell lung cancer; overall survival; pneumonia; primary health care; priority journal; prog