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Real-world data prognostic model of overall survival in patients with advanced NSCLC receiving anti-PD-1/PD-L1 immune checkpoint inhibitors as second-line monotherapy.
- Source :
-
Cancer reports (Hoboken, N.J.) [Cancer Rep (Hoboken)] 2022 Oct; Vol. 5 (10), pp. e1578. Date of Electronic Publication: 2022 Jan 24. - Publication Year :
- 2022
-
Abstract
- Background and Aim: The objective of this retrospective, observational, noninterventional cohort study was to investigate prognostic factors of overall survival (OS) in patients with advanced non-small cell lung cancer (aNSCLC) and to develop a novel prognostic model.<br />Methods: A total of 4049 patients with aNSCLC diagnosed between January 2011 and February 2020 who received atezolizumab, nivolumab, or pembrolizumab as second-line monotherapy were selected from a real-world deidentified database to build the cohort. Patients could not have received first-line treatment with clinical study drug(s) nor immune checkpoint inhibitors including anti-programmed cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1), and anti-cytotoxic T-lymphocyte-associated protein 4 therapies.<br />Results: Patients had a median age of 69 years; 45% were female, 75% White, 70% had stage IV at initial diagnosis, and 70% had nonsquamous histology. A Cox proportional hazards model with lasso regularization was used to build a prognostic model for OS using 18 baseline demographic and clinical factors based on the real-world data cohort. The risk-increasing prognostic factors were abnormally low albumin and chloride levels, Eastern Cooperative Oncology Group performance status score ≥ 2, and abnormally high levels of alkaline phosphatase and white blood cells. The risk-decreasing prognostic factors were PD-L1 positivity, longer time from advanced diagnosis to start of first-line therapy, and higher systolic blood pressure. The performance of the model was validated using data from the OAK trial, and the c-index for the OAK trial validation cohort was 0.65 and 0.67 for the real-world data cohort.<br />Conclusions: Based on baseline demographic and clinical factors from a real-world setting, this prognostic model was developed to discriminate the risk of death in patients with aNSCLC treated with checkpoint inhibitors as second-line monotherapy, and it performed well in the real-world data and clinical trial cohorts.<br /> (© 2022 F.Hoffmann-La Roche Ltd/Genentech, Inc. Cancer Reports published by Wiley Periodicals LLC.)
- Subjects :
- Aged
Albumins
Alkaline Phosphatase therapeutic use
B7-H1 Antigen metabolism
Chlorides therapeutic use
Cohort Studies
Female
Humans
Immune Checkpoint Inhibitors therapeutic use
Male
Nivolumab
Prognosis
Retrospective Studies
Antineoplastic Agents, Immunological therapeutic use
Carcinoma, Non-Small-Cell Lung
Lung Neoplasms
Programmed Cell Death 1 Receptor immunology
Subjects
Details
- Language :
- English
- ISSN :
- 2573-8348
- Volume :
- 5
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Cancer reports (Hoboken, N.J.)
- Publication Type :
- Academic Journal
- Accession number :
- 35075804
- Full Text :
- https://doi.org/10.1002/cnr2.1578