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
- Authors
- Park, J.H.; You, G.L.; Ahn, M.-J.; Kim, S.-W.; Hong, M.H.; Han, J.-Y.; Ock, C.-Y.; Lee, J.-S.; Oh, I.J.; Lee, S.Y.; Kim, C.H.; Min, Y.J.; Choi, Y.H.; Ryu, J.-S.; Park, S.H.; Ahn, H.K.; Shim, B.-Y.; Lee, K.H.; Lee, S.Y.; Kim, J.-S.; Yi, J.; Choi, S.K.; An, H.; Kang, J.H.
- Issue Date
- Aug-2021
- Publisher
- SPRINGER
- Keywords
- Biomarkers; Immune-checkpoint inhibitor; irAE; Non-small cell lung cancer; PD-L1; Real-world
- Citation
- Journal of Cancer Research and Clinical Oncology, v.147, no.8, pp.2459 - 2469
- Journal Title
- Journal of Cancer Research and Clinical Oncology
- Volume
- 147
- Number
- 8
- Start Page
- 2459
- End Page
- 2469
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/81607
- DOI
- 10.1007/s00432-021-03527-4
- ISSN
- 0171-5216
- 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. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.
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