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Immune-Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer With Uncommon Histology.
- Source :
-
Clinical lung cancer [Clin Lung Cancer] 2022 Jan; Vol. 23 (1), pp. e17-e28. Date of Electronic Publication: 2021 Jul 05. - Publication Year :
- 2022
-
Abstract
- Background: Immune-checkpoint inhibitors (ICIs) have significantly improved outcome of advanced non-small cell lung cancer (aNSCLC) patients. However, their efficacy remains uncertain in uncommon histologies (UH).<br />Materials and Methods: Data from ICI treated aNSCLC patients (April,2013-January,2021) in one Institution were retrospectively collected. Univariate and multivariate survival analyses were estimated by Kaplan-Meier and Cox proportional hazards regression model, respectively. Objective response rate (ORR) and disease control rate (DCR) were assessed.<br />Results: Of 375 patients, 79 (21.1%) had UH: 19 (24.1%) sarcomatoid carcinoma, 15 (19.0%) mucinous adenocarcinoma, 10 (12.6%) enteric adenocarcinoma, 8 (10.1%) adenocarcinoma not otherwise specified, 7 (8.9%) large-cell neuroendocrine carcinoma, 6 (7.6%) mixed histology non-adenosquamous, 5 (6.3%) adenosquamous carcinoma, 9 (11.4%) other UH. In UH group, programmed death-ligand 1 (PD-L1) <1%, 1-49%, ≥50% and unknown expression were reported in 27.8%, 22.8%, 31.7% and 17.7% patients respectively and ICI was the second/further-line in the majority of patients. After a median follow-up of 35.64 months (m), median progression-free survival (mPFS) was 2.5 m in UH [95% CI 2.2-2.9 m] versus (vs.) 2.7 m in CH [95% CI 2.3-3.2 m, P-value = .584]; median overall survival (mOS) was 8.8 m [95% CI 4.9-12.6 m] vs. 9.7 m [95% CI 8.0-11.3 m, P-value = .653]. At multivariate analyses only ECOG PS was a confirmed prognostic factor in UH. ORR and DCR were 25.3% and 40.5% in UH vs. 21.6% and 49.5% in CH [P-value = .493 and .155 respectively].<br />Conclusions: No significant differences were detected between UH and CH groups. Prospective trials are needed to understand ICIs role in UH population.<br /> (Copyright © 2021. Published by Elsevier Inc.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Proportional Hazards Models
Retrospective Studies
Survival Analysis
Carcinoma, Non-Small-Cell Lung drug therapy
Carcinoma, Non-Small-Cell Lung pathology
Immune Checkpoint Inhibitors pharmacology
Lung Neoplasms drug therapy
Lung Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1938-0690
- Volume :
- 23
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Clinical lung cancer
- Publication Type :
- Academic Journal
- Accession number :
- 34334296
- Full Text :
- https://doi.org/10.1016/j.cllc.2021.06.013