Therapy Line and Associated Predictors of Response to PD-1/PD-L1-Inhibitor Monotherapy in Advanced Non-small-Cell Lung Cancer: A Retrospective Bi-centric Cohort Study

• DOI: 10.1007/s11523-019-00679-9
• Publication Date: 2019-10-25T19:55:01Z
• Authors: David Lang; Florian Huemer; Gabriel Rinnerthaler; Andreas Horner; Romana Wass; Elmar Brehm; Kaveh Akbari; Marcel Granitz; Georg Hutarew; Bernhard Kaiser; Richard Greil; Bernd Lamprecht
• Keywords: Adult; Male; Lung Neoplasms; Programmed Cell Death 1 Receptor; Antibodies, Monoclonal, Humanized; B7-H1 Antigen; Cohort Studies; 03 medical and health sciences; Antineoplastic Agents, Immunological; 0302 clinical medicine; Predictive Value of Tests; Carcinoma, Non-Small-Cell Lung; Humans; Original Research Article; Aged; Retrospective Studies; Aged, 80 and over; Middle Aged; Progression-Free Survival; 3. Good health; Survival Rate; Nivolumab; Treatment Outcome; Female

Evidence on PD-1/PD-L1-directed immune checkpoint inhibitor (ICI) therapy for advanced non-small-cell lung cancer (NSCLC) is mainly based clinical trials in first- or second-line settings.We aimed to investigate response and prognostic factors with special regard third- later-line therapy.We retrospectively analyzed all patients who had received ICI monotherapy nivolumab, pembrolizumab, atezolizumab NSCLC. Computed tomography evaluations were using evaluation criteria solid tumors (RECIST, version 1.1). Kaplan-Meier analyses conducted calculate progression-free (PFS) overall (OS) survival; the impact of influencing variables was evaluated uni- multivariate Cox-regression analyses.Among 153 (59% men, mean age 66 years), median PFS 4 months [mo; 95% confidence interval (95% CI) 3-5], OS 13 mo (10-17), objective rate (ORR) 22%. Therapy line ≥ 3 associated significantly inferior (p = 0.003) 0.001). In first-line PFS, OS, ORR 7 (3-11), 17 [9-not evaluable (n.e.)], 36%; (3-7), 18 (13-n.e.) 19%, third-line 2 (1-3), 9 (4-12), 13%. influenced by PD-L1 expression 0.006). patients, Eastern Cooperative Oncology Group (ECOG) performance status affected (both p < 0.001).Third- single-agent anti-PD-1/PD-L1 less efficacious as compared treatment. that setting, ECOG predominates known predictors like presence an alteration EGFR ALK.