2022,
BMC Cancer.
DOI:
10.1186/s12885-022-09843-3
Real-world data analysis of immune checkpoint inhibitors in stage III-IV adenocarcinoma and squamous cell carcinoma
Meiling Sun
, Huaijun Ji
, Ning Xu
, Peng Jiang
, Tao Qu
, Yu Li
Abstract:
Abstract
Background
This study was designed to investigate the clinical application, efficacy, and safety of immune checkpoint inhibitors (ICIs) in the treatment of lung cancer in the real world.
Methods
A retrospective, observational analysis was conducted on patients treated with ICIs in four tertiary hospitals in the region from January 2015 to March 2021, to evaluate the clinical efficacy of ICIs single-agent or combined chemotherapy and anti-vascular drugs in the first-line or second-line treatment of patients with lung cancer.
Results
Three hundred and fifteen patients were enrolled in this study. In patients with stage III-IV adenocarcinoma and Squamous cell carcinoma, the objective response rate (ORR) and disease control rate (DCR) were 35.5% (87/245) and 93.5% (229/245), respectively, the median progression-free survival (PFS) was 10.8 months, and the median overall survival (OS) was not reached. A total of 132 patients received ICIs as the first-line treatment, the median treatment cycle was 8 cycles (2–20 cycles), the short-term efficacy ORR was 38.6%, DCR was 93.9%, and the median PFS was 11.4 months. One hundred thirteen patients received ICIs treatment as second-line treatment, the median treatment cycle was five cycles (2–10 cycles), the short-term efficacy ORR was 31.9%, DCR was 92.9%, and the median PFS was 10.0 months. There were no statistically significant differences in ORR, DCR, or median PFS with ICIs as the first-line treatment compared with the second-line treatment(P > 0.05). The results of subgroup analysis showed that Eastern Cooperative Oncology Group performance status (ECOG PS), epidermal growth factor receptor (EGFR) mutation status, pathological type and number of treatment lines were not correlated with median PFS(P > 0.05). However, there were statistically significant differences in programmed death-ligand 1(PD-L1) expression, corticosteroid interference, and antibiotic (Abx) treatment among all groups (P < 0.05). In terms of safety, the overall incidence of adverse reactions in 315 patients was 62.5%, and the incidence of immune-related adverse events (irAEs) was 13.7%. Grade 1–2 and 3–4 incidence of adverse events were 34.9 and 27.65%, respectively. There were four patients who experienced fatal irAEs, two cases were liver damage leading to liver failure, one case was immune related pneumonia, and one case was immune related myocarditis.
Conclusion
In the real world, ICIs has a good effect on patients with lung cancer and significantly improves ORR and PFS.
Related Links:
2023-07-11 02:13:00
龙海晨:
#paper Sun M, Ji H, Xu N, Jiang P, Qu T, Li Y. Real-world data analysis of immune checkpoint inhibitors in stage III-IV adenocarcinoma and squamous cell carcinoma. BMC Cancer. 2022 Jul 13;22(1):762. doi: 10.1186/s12885-022-09843-3. PMID: 35831785; PMCID: PMC9277844. 这是一篇临床上回顾性研究肺癌的文章，主要研究对象：III-IV期肺腺癌和鳞状细胞癌患者。使用免疫检查点抑制剂immune checkpoint inhibitors (ICIs)方法治疗后的情况。对315名患者使用ICIs疗法，并对患者进行评估，发现，ICIs对肺癌患者有良好的疗效，显著提高了患者生存期中位数，也缓解了症状。从结果数据看，使用ICIs也存在不良反应。