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Real-world outcomes of anti-PD1 antibodies in platinum-refractory, PD-L1-positive recurrent and/or metastatic non-small cell lung cancer, and its potential practical predictors: first report from Korean Cancer Study Group LU19-05

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Author(s)
Ji Hyun ParkGun Lyung YouMyung-Ju AhnSang-We KimMin Hee HongJi-Youn HanChan-Young OckJong-Seok LeeIn Jae OhShin Yup LeeCheol Hyeon KimYoung Joo MinYoon Hee ChoiJeong-Seon RyuSun Hyo ParkHee Kyung AhnByoung-Yong ShimKi Hyeong LeeSung Yong LeeJin-Soo KimJiun YiSu Kyung ChoiHyonggin AnJin Hyoung Kang
Keimyung Author(s)
Park, Sun Hyo
Department
Dept. of Internal Medicine (내과학)
Journal Title
J Cancer Res Clin Oncol
Issued Date
2021
Volume
147
Keyword
Immune-checkpoint inhibitorNon-small cell lung cancerReal-worldBiomarkersPD-L1irAE
Abstract
Purpose:
Although immune-checkpoint inhibitors have become a new therapeutic option for recurrent/metastatic non-small cell lung cancers (R/M-NSCLC), its clinical benefit in the real-world is still unclear.

Methods:
We investigated 1181 Korean patients with programmed death-1 ligand 1 (PD-L1)-positive [tumor proportion score (TPS) ≥ 10% by the SP263 assay or ≥ 50% by the 22C3 assay] R/M-NSCLC treated with pembrolizumab or nivolumab after failure of platinum-based chemotherapy.

Results:
The median age was 67 years, 13% of patients had ECOG-PS ≥ 2, and 27% were never-smokers. Adenocarcinoma was predominant (61%) and 18.1% harbored an EGFR activating mutation or ALK rearrangement. Pembrolizumab and nivolumab were administered to 51.3% and 48.7, respectively, and 42% received them beyond the third-line chemotherapy. Objective response rate (ORR) was 28.6%. Pembrolizumab group showed numerically higher ORR (30.7%) than the nivolumab group (26.4%), but it was comparable with that of the nivolumab group having PD-L1 TPS ≥ 50% (32.4%). Median progression-free survival (PFS) and overall survival (OS) were 2.9 (95% CI 0–27.9) and 10.7 months (95% CI 0–28.2), respectively. In multivariable analysis, concordance of TPS ≥ 50% in both PD-L1 assays and the development of immune-related adverse events (irAEs) were two significant predictors of better ORR, PFS, and OS. EGFR mutation could also predict significantly worse OS outcomes.

Conclusion:
The real-world benefit of later-line anti-PD1 antibodies was comparable to clinical trials in patients with R/M-NSCLC, although patients generally were more heavily pretreated and had poorer ECOG-PS. Concordantly high PD-L1 TPS ≥ 50% and development of irAE could independently predict better treatment outcomes, while EGFR mutation negatively affected OS.
Keimyung Author(s)(Kor)
박순효
Publisher
School of Medicine (의과대학)
Citation
Ji Hyun Park et al. (2021). Real-world outcomes of anti-PD1 antibodies in platinum-refractory, PD-L1-positive recurrent and/or metastatic non-small cell lung cancer, and its potential practical predictors: first report from Korean Cancer Study Group LU19-05. J Cancer Res Clin Oncol, 147, 2459–2469. doi: 10.1007/s00432-021-03527-4
Type
Article
ISSN
1432-1335
Source
https://link.springer.com/article/10.1007%2Fs00432-021-03527-4
DOI
10.1007/s00432-021-03527-4
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43612
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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