@article{3215698,
    title = "Effectiveness of PD-(L)1 Inhibitors Alone or in Combination With Platinum-Doublet Chemotherapy in First-Line (1L) Non-Squamous Non-Small Cell Lung Cancer (nsq-NSCLC)  With PD-L1-High Expression Using Real-World Data.",
    author = "Pérol, M. and Felip, E. and Dafni, U. and Polito, L. and Pal, N. and Tsourti, Z. and Ton, T. G. N. and Merritt, D. and Morris, S. and Stahel, R. and Peters, S.",
    journal = "Annals of oncology: official journal of the European Society for Medical Oncology",
    year = "2022",
    pages = "S0923--7534(22)00124--7",
    doi = "10.1016/j.annonc.2022.02.008",
    keywords = "immunotherapy, chemotherapy, Non-squamous non-small cell lung cancer, PD-L1 high, retrospective cohort",
    abstract = "BACKGROUND: Anti-PD-(L)1 therapy alone (cancer immunotherapy [CIT]-mono) or combined with platinum-based chemotherapy (CIT-chemo) is used as first-line treatment for  patients with metastatic non-small cell lung cancer (NSCLC). Our study compared  clinical outcomes with CIT-mono vs CIT-chemo in the specific clinical scenario of  non-squamous (Nsq)-NSCLC with a high PD-L1 expression of ≥50\% (tumor proportion  score (TPS) or tumor cells (TC)). METHODS: This was a retrospective cohort study  using a real-world de-identified database. Patients with metastatic Nsq-NSCLC with  high PD-L1 expression initiating first-line CIT-mono or CIT-chemo between 24 October  2016 and 28 February 2019 were followed up to 28 February 2020. We compared overall  survival (OS) and real-world progression-free survival (rwPFS) using Kaplan-Meier  methodology. Hazard ratios (HR) were adjusted (aHR) for differences in baseline key  prognostic characteristics using inverse probability of treatment weighting  methodology. RESULTS: Patients with PD-L1-high Nsq-NSCLC treated with CIT-mono  (n=351), were older and less often presented with de novo stage IV disease than  patients treated with CIT-chemo (n=169). With a median follow-up of 19.9 months for  CIT-chemo vs 23.5 months for CIT-mono, median OS and rwPFS did not differ between  the two groups (median OS: CIT-chemo, 21.0 months vs CIT-mono, 22.1 months,  aHR=1.03, 95\% CI 0.77-1.39, P=0.83; median rwPFS: CIT-chemo, 10.8 months vs  CIT-mono, 11.5 months, aHR=1.04, 95\% CI 0.78-1.37, P=0.81). CIT-chemo showed  significant and meaningful improvement in OS and rwPFS vs CIT-mono only in the  never-smoker subgroup, albeit among a small sample of patients (n=50; OS HR=0.25,  95\% CI 0.07-0.83, interaction P=0.02; rwPFS HR=0.40, 95\% CI 0.17-0.95, interaction  P=0.04). CONCLUSION: Except in the subgroup of never-smoker patients, sparing the  chemotherapy in first-line CIT treatment does not appear to impact survival outcomes  in Nsq-NSCLC patients with high PD-L1 expression."
}