BACKGROUND: Bone metastases and skeletal-related events (SREs) are a frequent cause of morbidity in patients with metastatic non-small cell lung cancer (mNSCLC). Data are limited on bone metastases and SREs in patients with mNSCLC treated using immune checkpoint inhibitors (ICIs), and on the efficacy of bone-modifying agents (BMAs) in this setting. Here we report the incidence, impact on survival, risk factors for bone metastases and SREs, and impact of BMAs in patients with mNSCLC treated with ICIs in a multi-institutional cohort. PATIENTS AND METHODS: We conducted a retrospective study of patients with mNSCLC treated with ICIs at 2 tertiary care centers from 2014 through 2017. Overall survival (OS) was compared between patients with and without baseline bone metastases using a log-rank test. A Cox regression model was used to evaluate the association between OS and the presence of bone metastases at ICI initiation, controlling for other confounding factors. RESULTS: We identified a cohort of 330 patients who had received ICIs for metastatic disease. Median patient age was 63 years, most patients were treated in the second line or beyond (n=259; 78%), and nivolumab was the most common ICI (n=211; 64%). Median OS was 10 months (95% CI, 8.4-12.0). In our cohort, 124 patients (38%) had baseline bone metastases, and 43 (13%) developed SREs during or after ICI treatment. Patients with bone metastases had a higher hazard of death after controlling for performance status, histology, line of therapy, and disease burden (hazard ratio, 1.57; 95% CI, 1.19-2.08; P=.001). Use of BMAs was not associated with OS or a decreased risk of SREs. CONCLUSIONS: Presence of bone metastases at baseline was associated with a worse prognosis for patients with mNSCLC treated with ICI after controlling for multiple clinical characteristics. Use of BMAs was not associated with reduced SREs or a difference in survival.
BACKGROUND: Bone metastases and skeletal-related events (SREs) are a frequent cause of morbidity in patients with metastatic non-small cell lung cancer (mNSCLC). Data are limited on bone metastases and SREs in patients with mNSCLC treated using immune checkpoint inhibitors (ICIs), and on the efficacy of bone-modifying agents (BMAs) in this setting. Here we report the incidence, impact on survival, risk factors for bone metastases and SREs, and impact of BMAs in patients with mNSCLC treated with ICIs in a multi-institutional cohort. PATIENTS AND METHODS: We conducted a retrospective study of patients with mNSCLC treated with ICIs at 2 tertiary care centers from 2014 through 2017. Overall survival (OS) was compared between patients with and without baseline bone metastases using a log-rank test. A Cox regression model was used to evaluate the association between OS and the presence of bone metastases at ICI initiation, controlling for other confounding factors. RESULTS: We identified a cohort of 330 patients who had received ICIs for metastatic disease. Median patient age was 63 years, most patients were treated in the second line or beyond (n=259; 78%), and nivolumab was the most common ICI (n=211; 64%). Median OS was 10 months (95% CI, 8.4-12.0). In our cohort, 124 patients (38%) had baseline bone metastases, and 43 (13%) developed SREs during or after ICI treatment. Patients with bone metastases had a higher hazard of death after controlling for performance status, histology, line of therapy, and disease burden (hazard ratio, 1.57; 95% CI, 1.19-2.08; P=.001). Use of BMAs was not associated with OS or a decreased risk of SREs. CONCLUSIONS: Presence of bone metastases at baseline was associated with a worse prognosis for patients with mNSCLC treated with ICI after controlling for multiple clinical characteristics. Use of BMAs was not associated with reduced SREs or a difference in survival.
Authors: Leena Gandhi; Delvys Rodríguez-Abreu; Shirish Gadgeel; Emilio Esteban; Enriqueta Felip; Flávia De Angelis; Manuel Domine; Philip Clingan; Maximilian J Hochmair; Steven F Powell; Susanna Y-S Cheng; Helge G Bischoff; Nir Peled; Francesco Grossi; Ross R Jennens; Martin Reck; Rina Hui; Edward B Garon; Michael Boyer; Belén Rubio-Viqueira; Silvia Novello; Takayasu Kurata; Jhanelle E Gray; John Vida; Ziwen Wei; Jing Yang; Harry Raftopoulos; M Catherine Pietanza; Marina C Garassino Journal: N Engl J Med Date: 2018-04-16 Impact factor: 91.245
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Authors: Giorgio Vittorio Scagliotti; Vera Hirsh; Salvatore Siena; David H Henry; Penella J Woll; Christian Manegold; Philippe Solal-Celigny; Gladys Rodriguez; Maciej Krzakowski; Nilesh D Mehta; Lara Lipton; José Angel García-Sáenz; José Rodrigues Pereira; Kumar Prabhash; Tudor-Eliade Ciuleanu; Vladimir Kanarev; Huei Wang; Arun Balakumaran; Ira Jacobs Journal: J Thorac Oncol Date: 2012-12 Impact factor: 15.609
Authors: Juan C Osorio; Kathryn C Arbour; Dung T Le; Jennifer N Durham; Andrew J Plodkowski; Darragh F Halpenny; Michelle S Ginsberg; Peter Sawan; Joseph G Crompton; Helena A Yu; Azadeh Namakydoust; Barzin Y Nabet; Jamie E Chaft; Gregory J Riely; Hira Rizvi; Luis A Diaz; Matthew D Hellmann Journal: J Clin Oncol Date: 2019-11-01 Impact factor: 44.544
Authors: Danna L Arellano; Patricia Juárez; Andrea Verdugo-Meza; Paloma S Almeida-Luna; Juan A Corral-Avila; Florian Drescher; Felipe Olvera; Samanta Jiménez; Bennett D Elzey; Theresa A Guise; Pierrick G J Fournier Journal: J Bone Miner Res Date: 2022-06-17 Impact factor: 6.390