Affiliation:
1. Division of Hematology-Oncology, Department of Internal Medicine, Ewha Womans University Medical Center, Ewha Womans University College of Medicine, Seoul 07985, Republic of Korea
2. Division of Hematology-Oncology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul 05368, Republic of Korea
3. Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul 05368, Republic of Korea
Abstract
Purpose: To provide a comprehensive analysis of ICI usage and treatment outcomes in elderly Korean veterans with stage IV NSCLC. Methods: Patients diagnosed with stage IV NSCLC between 2016 and 2021 were included, and three cohorts were derived according to the type of ICI received. Thereafter, the clinical characteristics and survival outcomes were compared. Results: Of the 180 patients with NSCLC (median age, 76 years) included in this study, 49 (27.7%), 61 (33.9%), and 70 (38.9%) received pembrolizumab, nivolumab, and atezolizumab, respectively, and 19.4%, 36.1%, and 34.4% had PD-L1 expressions < 1%, 1–49%, and ≥50%, respectively. The pembrolizumab, nivolumab, and atezolizumab groups, the objective response rates (ORR), and the disease control rates (DCR) were 22.4%, 8.2%, and 4.3% (p = 0.004), and 59.2, 55.7%, and 30.0% (p = 0.001), respectively. However, no difference in the overall survival (OS) rate was noted among the groups (12.6 months vs. 8.4 months vs. 7.7 months, p = 0.334). Similarly, there was no treatment specific OS benefit with respect to the tumor PD-L1 expression status. Interestingly, multivariate analysis identified bone metastasis as a significant poor prognostic factor for OS (HR = 2.75 [95% CI, 1.31–5.76], p = 0.007). Conclusion: Pembrolizumab and nivolumab showed stronger associations with increases in ORR and DCR than atezolizumab, but no statistically significant differences were observed with respect to OS.
Reference33 articles.
1. (2023, January 01). Cancer Stat Facts Lung and Bronchus Cancer, Available online: https://seer.cancer.gov/statfacts/html/lungb.html.
2. Current who guidelines and the critical role of immunohistochemical markers in the subclassification of non-small cell lung carcinoma (nsclc): Moving from targeted therapy to immunotherapy;Osmani;Semin. Cancer Biol.,2018
3. Roles of pd-1/pd-l1 pathway: Signaling, cancer, and beyond;Ai;Adv. Exp. Med. Biol.,2020
4. Immunotherapy in non-small cell lung cancer: Facts and hopes;Doroshow;Clin. Cancer Res.,2019
5. Pembrolizumab versus docetaxel for previously treated, pd-l1-positive, advanced non-small-cell lung cancer (keynote-010): A randomised controlled trial;Herbst;Lancet,2016
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