Κατεύθυνση Καρκίνος Πνεύμονα: Σύγχρονη Κλινικοεργαστηριακή Προσέγγιση και Έρευνα
Library of the School of Health Sciences

2021-08-19

2021

Mitsogianni Maria

Κωνσταντίνος Ν. Συρίγος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ηλίας Κοττέας, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δήμητρα Στεφάνου, Διδάκτωρ, Ιατρική Σχολή, ΕΚΠΑ

Σύγκριση ασφάλειας και αποτελεσματικότητας των αναστολέων σημείων ελέγχου μετά την αποτυχία της χημειοθεραπείας στον μη μικροκυτταρικό καρκίνο πνεύμονα

Greek

Comparative safety and efficacy of immune checkpoint inhibitors after failure of chemotherapy in non-small cell lung cancer

Introduction
Both pembrolizumab and nivolumab have been established as valid options in second and further-line treatment of non-small cell lung cancer, despite the lack of direct comparison in a randomized clinical trial. The aim of this study was to examine possible differences of efficacy and safety between pembrolizumab and nivolumab in this group of patients.
Methods
Patients with non-small cell lung cancer receiving second and further-line immunotherapy with either pembrolizumab or nivolumab in our hospital from 01/2017 – 01/2020 were retrospectively analysed. We collected data on demographics, overall response rate (ORR), progression-free survival (PFS), duration of response (DOR) and immune-related toxicity. Analysis included comparison of the two immunotherapeutics and determination of factors associated with prognosis.
Results
Sample consisted of 196 patients with a mean age of 66.6 years. 46 patients (23.5%) were treated with pembrolizumab and 150 (76.5%) with nivolumab. Baseline characteristics were similar (p>0.05), except for PD-L1 expression, which was higher in the pembrolizumab group (p<0.001). There were no differences regarding ORR and DCR (18.2 vs. 22.6% and 54.3 vs. 49.4% respectively, p=0.252), PFS (5.0 vs. 4.0 months, p=0.520), DOR (not estimated vs. 11.0 months, p=0.662) and immune-related toxicity (34.8 vs. 31.3%, p=0.549) between the two
groups. Multivariate analysis revealed immune-relate toxicity (HR 0.35, 95% CI 0.23 ─ 0.52, p<0.001) and performance status ≥ 2 (HR 1.86, 95% CI 1.30 ─ 2.65, p<0.001) as the only predictive factors for disease progression. Immune-related toxicity was associated with longer DOR as well (HR 0.44, 95% CI 0.25 ─ 0.79).
Conclusions
Our findings support that pembrolizumab and nivolumab present similar efficacy and safety in second and further-line setting. Immune-related toxicity and performance status are factors independently affecting prognosis.

Health Sciences

Non-small cell lung cancer, Immunotherapy

No

0

Yes

47

84

File access is restricted only to the intranet of UoA.

https://pergamos.lib.uoa.gr/uoa/dl/object/2959636