Tao Jiang1, Hongcheng Liu2, Meng Qiao1, Xuefei Li3, Chao Zhao3, Chunxia Su4, Shengxiang Ren5, Caicun Zhou6. 1. Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, People's Republic of China. 2. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, People's Republic of China. 3. Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, People's Republic of China. 4. Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, People's Republic of China. Electronic address: susu_mail@126.com. 5. Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, People's Republic of China. Electronic address: harry_ren@126.com. 6. Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, People's Republic of China. Electronic address: caicunzhou_dr@163.com.
Abstract
BACKGROUND: The current study aimed to comprehensively investigate the impact of various clinicopathologic features on the efficacy of programmed cell death-1 (PD-1) and ligand (PD-L1) inhibitors in patients with previously treated non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Randomized controlled trials that compared PD-1/PD-L1-inhibitor monotherapy with chemotherapy or placebo in patients with previously treated NSCLC were included. RESULTS: Five trials were included (n = 3025). For all studies, PD-1/PD-L1 inhibitors significantly prolonged overall survival (OS) (hazard ratio [HR], 0.70; P < .001) and progression-free survival (PFS) versus chemotherapy (HR, 0.86; P = .020). Subgroup analysis showed that anti-PD-1/PD-L1 monotherapy could markedly improve OS in elderly patients (HR, 0.69; P < .001), female patients (HR, 0.70; P < .001), never-smoking patients (HR, 0.73; P = .001), and patients with a histology of squamous cell carcinoma (HR, 0.67; P < .001), but not PFS in the elderly and female patient groups. Notably, PD-1/PD-L1 inhibitors cannot prolong both OS (HR, 0.76; P = .390) and PFS (HR, 0.74; P = .210) in patients with central nervous system (CNS) metastasis, whereas patients without CNS metastasis could benefit from anti-PD-1/PD-L1 monotherapy on OS (HR, 0.71; P < .001). CONCLUSION: PD-1/PD-L1-inhibitor monotherapy could significantly prolong both OS and PFS in patients with previously treated NSCLC. Subgroup analyses showed that most patients including elderly, females, never-smokers, and patients with squamous cell carcinomas do benefit. However, whether patients with CNS metastasis could benefit from anti-PD-1/PD-L1 monotherapy requires further validation.
BACKGROUND: The current study aimed to comprehensively investigate the impact of various clinicopathologic features on the efficacy of programmed cell death-1 (PD-1) and ligand (PD-L1) inhibitors in patients with previously treated non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Randomized controlled trials that compared PD-1/PD-L1-inhibitor monotherapy with chemotherapy or placebo in patients with previously treated NSCLC were included. RESULTS: Five trials were included (n = 3025). For all studies, PD-1/PD-L1 inhibitors significantly prolonged overall survival (OS) (hazard ratio [HR], 0.70; P < .001) and progression-free survival (PFS) versus chemotherapy (HR, 0.86; P = .020). Subgroup analysis showed that anti-PD-1/PD-L1 monotherapy could markedly improve OS in elderly patients (HR, 0.69; P < .001), female patients (HR, 0.70; P < .001), never-smoking patients (HR, 0.73; P = .001), and patients with a histology of squamous cell carcinoma (HR, 0.67; P < .001), but not PFS in the elderly and female patient groups. Notably, PD-1/PD-L1 inhibitors cannot prolong both OS (HR, 0.76; P = .390) and PFS (HR, 0.74; P = .210) in patients with central nervous system (CNS) metastasis, whereas patients without CNS metastasis could benefit from anti-PD-1/PD-L1 monotherapy on OS (HR, 0.71; P < .001). CONCLUSION:PD-1/PD-L1-inhibitor monotherapy could significantly prolong both OS and PFS in patients with previously treated NSCLC. Subgroup analyses showed that most patients including elderly, females, never-smokers, and patients with squamous cell carcinomas do benefit. However, whether patients with CNS metastasis could benefit from anti-PD-1/PD-L1 monotherapy requires further validation.
Authors: Da Hyun Kang; Chaeuk Chung; Ju-Ock Kim; Sung Soo Jung; Hee Sun Park; Dong Il Park; Sun Young Jung; Myoungrin Park; Jeong Eun Lee Journal: Thorac Cancer Date: 2018-09-25 Impact factor: 3.500