TY - JOUR
TI - 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.
AU - Pérol, M.
AU - Felip, E.
AU - Dafni, U.
AU - Polito, L.
AU - Pal, N.
AU - Tsourti, Z.
AU - Ton, T. G. N.
AU - Merritt, D.
AU - Morris, S.
AU - Stahel, R.
AU - Peters, S.
JO - Annals of oncology: official journal of the European Society for Medical Oncology
PY - 2022
VL - null
TODO - null
SP - S0923--7534(22)00124--7
PB - 
SN - null
TODO - 10.1016/j.annonc.2022.02.008
TODO - immunotherapy, chemotherapy, Non-squamous non-small cell lung cancer, PD-L1 high, retrospective cohort
TODO - 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.
ER -