Bibliographic Details
| Title: |
Use of Different Anti-PD-1 Checkpoint Combination Strategies for First-Line Advanced NSCLC Treatment—The Experience of Ion Chiricuță Oncology Institute. |
| Authors: |
Preda, Alexandra-Cristina1,2 (AUTHOR) madalina.prodan06@gmail.com, Ciuleanu, Tudor-Eliade1,2 (AUTHOR) dadi.varro@gmail.com, Todor, Nicolae1 (AUTHOR) tdrnicolae@gmail.com, Vlad, Cătălin1,2 (AUTHOR) catalinvlad@yahoo.it, Iancu, Dana Ioana1 (AUTHOR) dana_iancu2004@yahoo.com, Mocan, Cristina1 (AUTHOR) mocan.cristina@gmail.com, Bandi-Vasilica, Mariana1 (AUTHOR) bandi.vmariana@gmail.com, Albu, Florina1 (AUTHOR) florinaalbu18@gmail.com, Todor-Bondei, Irina Mihaela1 (AUTHOR) airina202003@yahoo.com, Hapca, Mădălina Claudia2 (AUTHOR), Kubelac, Milan-Paul1 (AUTHOR) paulkubelac@gmail.com, Kubelac-Varro, Adelina Dadiana2 (AUTHOR) |
| Source: |
Cancers. Jun2024, Vol. 16 Issue 11, p2022. 26p. |
| Subject Terms: |
*THERAPEUTIC use of monoclonal antibodies, *CANCER treatment, *RESEARCH funding, *IMMUNOTHERAPY, *CLINICAL trials, *TREATMENT effectiveness, *CANCER patients, *MULTIVARIATE analysis, *AGE distribution, *DESCRIPTIVE statistics, *ADJUVANT chemotherapy, *COMBINED modality therapy, *DRUG efficacy, *STATISTICS, *LUNG cancer, *NIVOLUMAB, *PROGRESSION-free survival, *SPECIALTY hospitals, *IPILIMUMAB, *OVERALL survival, *EVALUATION |
| Geographic Terms: |
ROMANIA |
| Abstract: |
Simple Summary: Different immunotherapy combinations improved prognosis for advanced non-oncogene driven NSCLC, but they were not directly compared. The aim of our study is to present the real-world data for 122 patients treated at the Institute of Oncology in Cluj-Napoca with three different consecutive immunotherapy combinations (dual immunotherapy—18 patients, dual immunotherapy plus short course chemotherapy—33 patients, mono-immunotherapy plus full course chemotherapy—71 patients). Efficacy results using different immunotherapy combination strategies were in line with those from the registration trials, with 22.2 months median overall survival and 49% actuarial 2-year survival. Results were not significantly different between the three protocols. Older age, impaired performance status, corticotherapy in the first month of immunotherapy, and >3.81 neutrophils to lymphocytes ratio were independent unfavorable prognostic factors in the multivariate survival analysis. Long-term data are available for the dual immunotherapy cohorts, with 30.5% and 18.8% of patients alive at 5 years. Purpose. Different combination modalities between an anti-PD-1/PD-L1 agent and a platinum-based chemotherapy or another checkpoint inhibitor (with or without a short course or full course of a platinum doublet) proved superior to chemotherapy alone in multiple clinical trials, but these strategies were not directly compared. The aim of this study is to report the real-world data results with different immunotherapy combinations in a series of patients treated in consecutive cohorts at the Ion Chiricuță Oncology Institute. Methods. A total of 122 patients were successively enrolled in three cohorts: (1A) nivolumab + ipilimumab (18 patients), (1B) nivolumab + ipilimumab + short-course chemotherapy (33 patients), and (2) pembrolizumab plus full-course chemotherapy (71 patients). Endpoints included overall survival (OS), progression-free survival (PFS), objective response (ORR), and univariate and multivariate exploratory analysis of prognostic factors. RESULTS. Median follow-up in the consecutive cohorts 1A, 1B, and 2 was 83 versus 59 versus 14.2 months. Median OS and PFS for all patients were 22.2 and 11.5 months, respectively, and 2-year actuarial OS and PFS were 49% and 35%, respectively. For the nivolumab + ipilimumab (cohorts 1A and 1B) versus pembrolizumab combinations (cohort 2), median OS was 14 vs. 24.8 months (p = 0.18) and 2-year actuarial survival 42% vs. 53%; median PFS was 8.6 vs. 12.7 months (p = 0.41) and 2-year actuarial PFS 34% vs. 35%; response rates were 33.3% vs. 47.9% (p = 0.22). Older age, impaired PS (2 versus 0–1), corticotherapy in the first month of immunotherapy, and >3.81 neutrophils to lymphocytes ratio were independent unfavorable prognostic factors in the multivariate analysis of survival (limited to 2 years follow-up). The 5-year long-term survival was 30.5% and 18.8% for cohorts 1A and 1B, respectively (not enough follow-up for cohort 2). Conclusions. Efficacy results using different immunotherapy combination strategies were promising and not significantly different between protocols at 2 years. Real-world efficacy and long-term results in our series were in line with those reported in the corresponding registration trials. [ABSTRACT FROM AUTHOR] |
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