Efficacy of Immune Checkpoint Inhibitor With or Without Chemotherapy for Nonsquamous NSCLC With Malignant Pleural Effusion: A Retrospective Multicenter Cohort Study

• DOI: 10.1016/j.jtocrr.2022.100355
• Publication Date: 2022-06-03T17:03:13Z
• Authors: Hayato Kawachi; Motohiro Tamiya; Yoshihiko Taniguchi; Toshihide Yokoyama; Shinya Yokoe; Yuko Oya; Mihoko Imaji; Fukuko Okabe; Masaki Kanazu; Yoshihiko Sakata; Shinya Uematsu; Satoshi Tanaka; Daisuke Arai; Go Saito; Hiroshi Kobe; Eisaku Miyauchi; Asuka Okada; Satoshi Hara; Toru Kumagai
• Keywords: Progression-free survival

Malignant pleural effusion (MPE) is associated with poor treatment outcome in patients NSCLC receiving immune checkpoint inhibitors (ICIs). ICIs and chemotherapy (ICI/Chemo) combination therapy currently the standard for NSCLC, some ICI/Chemo regimens nonsquamous (non-Sq) contain bevacizumab (BEV), which effective controlling MPE may enhance response. This study aimed to determine optimal first-line this clinical population.We retrospectively enrolled consecutive non-Sq who received or pembrolizumab monotherapy. Treatment outcomes were analyzed programmed death-ligand 1 (PD-L1) tumor proportion score more than equal 50% administered monotherapy (PD-L1 high cohort) any PD-L1 status, treated without BEV (ICI/Chemo cohort). We used propensity matching (PSM) reduce bias.PD-L1 cohorts included 143 139 patients, respectively. In cohort, 37 ICI/Chemo. With PSM, median progression-free survival was significantly longer group (11.1 versus 3.9 mo, respectively, p = 0.0409). 23 BEV. no significant difference occurred between non-BEV groups (6.1 7.4 0.9610).ICI/Chemo seemed MPE. Nevertheless, synergistic effect of be limited. Further studies are needed clarify key factor tumor-induced immunosuppression environment these patients.