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PD-1/PD-L1 checkpoint inhibitors during late stages of life: an ad-hoc analysis from a large multicenter cohort.
Santini, Daniele; Zeppola, Tea; Russano, Marco; Citarella, Fabrizio; Anesi, Cecilia; Buti, Sebastiano; Tucci, Marco; Russo, Alessandro; Sergi, Maria Chiara; Adamo, Vincenzo; Stucci, Luigia S; Bersanelli, Melissa; Mazzaschi, Giulia; Spagnolo, Francesco; Rastelli, Francesca; Giorgi, Francesca Chiara; Giusti, Raffaele; Filetti, Marco; Marchetti, Paolo; Botticelli, Andrea; Gelibter, Alain; Siringo, Marco; Ferrari, Marco; Marconcini, Riccardo; Vitale, Maria Giuseppa; Nicolardi, Linda; Chiari, Rita; Ghidini, Michele; Nigro, Olga; Grossi, Francesco; De Tursi, Michele; Di Marino, Pietro; Pala, Laura; Queirolo, Paola; Bracarda, Sergio; Macrini, Serena; Gori, Stefania; Inno, Alessandro; Zoratto, Federica; Tanda, Enrica T; Mallardo, Domenico; Vitale, Maria Grazia; Talbot, Thomas; Ascierto, Paolo A; Pinato, David J; Ficorella, Corrado; Porzio, Giampiero; Cortellini, Alessio.
Afiliação
  • Santini D; Medical Oncology, Campus Bio-Medico University, Rome, Italy.
  • Zeppola T; Medical Oncology, Campus Bio-Medico University, Rome, Italy.
  • Russano M; Medical Oncology, Campus Bio-Medico University, Rome, Italy.
  • Citarella F; Medical Oncology, Campus Bio-Medico University, Rome, Italy.
  • Anesi C; Medical Oncology, Campus Bio-Medico University, Rome, Italy.
  • Buti S; Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
  • Tucci M; Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy.
  • Russo A; National Cancer Research Center, Tumori Institute IRCCS Giovanni PaoloII, Bari, Italy.
  • Sergi MC; Medical Oncology, A.O. Papardo & Department of Human Pathology, University of Messina, Messina, Italy.
  • Adamo V; Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy.
  • Stucci LS; Medical Oncology, A.O. Papardo & Department of Human Pathology, University of Messina, Messina, Italy.
  • Bersanelli M; Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy.
  • Mazzaschi G; Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
  • Spagnolo F; Department of Medicine and Surgery, University of Parma, Parma, Italy.
  • Rastelli F; Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
  • Giorgi FC; IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • Giusti R; UOC Oncologia Ascoli Piceno - San Benedetto del Tronto, Area Vasta 5, ASUR Marche, Ancona, Italy.
  • Filetti M; UOC Oncologia Ascoli Piceno - San Benedetto del Tronto, Area Vasta 5, ASUR Marche, Ancona, Italy.
  • Marchetti P; Medical Oncology Unit, Sant' Andrea Hospital of Rome, Rome, Italy.
  • Botticelli A; Medical Oncology Unit, Sant' Andrea Hospital of Rome, Rome, Italy.
  • Gelibter A; Medical Oncology Unit, Sant' Andrea Hospital of Rome, Rome, Italy.
  • Siringo M; Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.
  • Ferrari M; Medical Oncology (B), Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
  • Marconcini R; Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.
  • Vitale MG; Medical Oncology (B), Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
  • Nicolardi L; Medical Oncology (B), Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
  • Chiari R; Medical Oncology (B), Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
  • Ghidini M; Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
  • Nigro O; Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
  • Grossi F; Medical Oncology, University Hospital of Modena, Modena, Italy.
  • De Tursi M; UOC Oncologia Padova Sud - AULSS6 Euganea, Padova, Italy.
  • Di Marino P; UOC Oncologia Padova Sud - AULSS6 Euganea, Padova, Italy.
  • Pala L; Medical Oncology Unit, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Queirolo P; Medical Oncology, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
  • Bracarda S; Division of Medical Oncology, University of Insubria, Varese, Italy.
  • Macrini S; Department of Medical, Oral & Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Italy.
  • Gori S; Clinical Oncology Unit, S.S. Annunziata Hospital, Chieti, Italy.
  • Inno A; Division of Medical Oncology for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy.
  • Zoratto F; Division of Medical Oncology for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy.
  • Tanda ET; S.C. Medical Oncology, Azienda Ospedaliera S. Maria, Terni, Italy.
  • Mallardo D; S.C. Medical Oncology, Azienda Ospedaliera S. Maria, Terni, Italy.
  • Vitale MG; Oncology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, VR, Italy.
  • Talbot T; Oncology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, VR, Italy.
  • Ascierto PA; Medical Oncology, Santa Maria Goretti Hospital, Latina, Italy.
  • Pinato DJ; IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • Ficorella C; Genetics of Rare Cancers, Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy.
  • Porzio G; Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori-IRCCS Fondazione "G. Pascale", Naples, Italy.
  • Cortellini A; Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori-IRCCS Fondazione "G. Pascale", Naples, Italy.
J Transl Med ; 19(1): 270, 2021 06 24.
Article em En | MEDLINE | ID: mdl-34167578
BACKGROUND: The favourable safety profile and the increasing confidence with immune checkpoint inhibitors (ICIs) might have boosted their prescription in frail patients with short life expectancies, who usually are not treated with standard chemotherapy. METHODS: The present analysis aims to describe clinicians' attitudes towards ICIs administration during late stages of life within a multicenter cohort of advanced cancer patients treated with single agent PD-1/PD-L1 checkpoint inhibitors in Italy. RESULTS: Overall, 1149 patients with advanced cancer who received single agent PD-1/PD-L1 checkpoint inhibitors were screened. The final study population consisted of 567 deceased patients. 166 patients (29.3%) had received ICIs within 30 days of death; among them there was a significantly higher proportion of patients with ECOG-PS ≥ 2 (28.3% vs 11.5%, p < 0.0001) and with a higher burden of disease (69.3% vs 59.4%, p = 0.0266). In total, 35 patients (6.2%) started ICIs within 30 days of death; among them there was a higher proportion of patients with ECOG-PS ≥ 2 (45.7% vs 14.5%, p < 0.0001) and with a higher burden of disease (82.9% vs 60.9%, p = 0.0266). Primary tumors were significantly different across subgroups (p = 0.0172), with a higher prevalence of NSCLC patients (80% vs 60.9%) among those who started ICIs within 30 days of death. Lastly, 123 patients (21.7%) started ICIs within 3 months of death. Similarly, within this subgroup there was a higher proportion of patients with ECOG-PS ≥ 2 (29.3% vs 12.8%, p < 0.0001), with a higher burden of disease (74.0% vs 59.0%, p = 0.0025) and with NSCLC (74.0% vs 58.8%, p = 0.0236). CONCLUSION: Our results confirmed a trend toward an increasing ICIs prescription in frail patients, during the late stages of life. Caution should be exercised when evaluating an ICI treatment for patients with a poor PS and a high burden of disease.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Antígeno B7-H1 / Neoplasias Pulmonares Tipo de estudo: Clinical_trials / Risk_factors_studies Limite: Humans País/Região como assunto: Europa Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Antígeno B7-H1 / Neoplasias Pulmonares Tipo de estudo: Clinical_trials / Risk_factors_studies Limite: Humans País/Região como assunto: Europa Idioma: En Ano de publicação: 2021 Tipo de documento: Article