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Outcomes to first-line pembrolizumab in patients with PD-L1-high (≥50%) non-small cell lung cancer and a poor performance status.
Alessi, Joao V; Ricciuti, Biagio; Jiménez-Aguilar, Elizabeth; Hong, Fangxin; Wei, Zihan; Nishino, Mizuki; Plodkowski, Andrew J; Sawan, Peter; Luo, Jia; Rizvi, Hira; Carter, Brett W; Heymach, John V; Altan, Mehmet; Hellmann, Matthew; Awad, Mark.
Afiliação
  • Alessi JV; Lowe Center for Thoracic Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA.
  • Ricciuti B; Lowe Center for Thoracic Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA.
  • Jiménez-Aguilar E; Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Comunidad de Madrid, Spain.
  • Hong F; Department of Data Sciences, Dana Farber Cancer Institute, Boston, Massachusetts, USA.
  • Wei Z; Department of Data Sciences, Dana Farber Cancer Institute, Boston, Massachusetts, USA.
  • Nishino M; Department of Radiology, Dana Farber Cancer Institute, Boston, Massachusetts, USA.
  • Plodkowski AJ; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Sawan P; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Luo J; Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Rizvi H; Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Carter BW; Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Heymach JV; Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Altan M; Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Hellmann M; Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Awad M; Lowe Center for Thoracic Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA mark_awad@dfci.harvard.edu.
J Immunother Cancer ; 8(2)2020 08.
Article em En | MEDLINE | ID: mdl-32753547
BACKGROUND: Patients with non-small cell lung cancer (NSCLC) and a poor Eastern Cooperative Oncology Group Performance Status (ECOG PS) have been excluded from phase III immunotherapy clinical trials. We sought to evaluate clinical outcomes to first-line pembrolizumab in patients with advanced NSCLC, a PD-L1 Tumor Proportion Score (TPS) of ≥50%, and an ECOG PS of 2. METHODS: We performed a multicenter retrospective analysis of patients with metastatic NSCLC and a PD-L1 TPS of ≥50% (negative for genomic alterations in EGFR and ALK) who received treatment with first-line pembrolizumab. Clinical outcomes were compared in patients based on ECOG PS. RESULTS: Among the 234 patients, 83.3% (n=195) had an ECOG PS of 0 or 1, and 16.7% (n=39) had an ECOG PS of 2. The baseline clinicopathological characteristics were balanced between the ECOG PS 0-1 vs 2 groups in terms of age, sex, tobacco use, histology, KRAS mutation status, presence of other potentially targetable driver mutations (BRAF, MET, HER2, RET), presence of brain metastases, and PD-L1 TPS distribution. Compared with patients with an ECOG PS of 0 or 1, patients with an ECOG PS of 2 had a significantly lower objective response rate (43.1% vs 25.6%; p=0.04), a numerically shorter median progression-free survival (6.6 months vs 4.0 months; HR 0.70 (95% CI 0.47 to 1.06); p=0.09), and a significantly shorter median overall survival (20.3 months vs 7.4 months; HR 0.42 (95% CI 0.26 to 0.68); p<0.001). On disease progression, patients with an ECOG PS of 2 were significantly less likely to receive second-line systemic therapy compared with patients with an ECOG PS of 0-1 (65% vs 22.2%, p=0.001). CONCLUSIONS: A subset of patients with NSCLC and an ECOG PS of 2 can respond to first-line pembrolizumab. However, clinical outcomes in this population are often poor and use of second-line systemic therapy is infrequent.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Anticorpos Monoclonais Humanizados / Antígeno B7-H1 / Imunoterapia / Neoplasias Pulmonares Tipo de estudo: Observational_studies Limite: Aged / Female / Humans / Male Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Anticorpos Monoclonais Humanizados / Antígeno B7-H1 / Imunoterapia / Neoplasias Pulmonares Tipo de estudo: Observational_studies Limite: Aged / Female / Humans / Male Idioma: En Ano de publicação: 2020 Tipo de documento: Article