INTRODUCTION: Immunotherapy has prolonged the time that NSCLC patients are off platinum-based (PB) chemotherapy. However, the significance of the platinum-free-interval (PFI) is unclear. We evaluated whether an optimal PFI exists in NSCLC for PB re-exposure in contemporary treatment settings. METHODS: We conducted a retrospective cohort study of patients with metastatic NSCLC treated with 1st-line PB chemotherapy with or without immunotherapy. Using multivariable Cox models stratified by treatment strategies, we evaluated whether salvage PB vs. nonPB chemotherapy resulted in superior outcomes and whether this was modulated by the PFI. RESULTS: A total of 751 patients treated with salvage chemotherapy after PB chemoimmunotherapy were identified in 2 treatment strategy cohorts: 3rd-line after sequential chemotherapy and immunotherapy (Sequential Chemo IO, n = 604); 2ndline after chemoimmunotherapy (Concurrent ChemoIO, n = 147). An optimal PFI of 5 and 6 months was identified in the Sequential Chemo IO and Concurrent ChemoIO cohorts, respectively, but there was no overall survival or progression free survival advantage for PB vs. nonPB chemotherapy in long or short PFI groups. CONCLUSION: An optimal PFI was identified in this contemporary NSCLC cohort treated with two common immunotherapy-containing treatment approaches, but PFI threshold did not predict benefit from platinum re-exposure as it has in other malignancies.
INTRODUCTION: Immunotherapy has prolonged the time that NSCLC patients are off platinum-based (PB) chemotherapy. However, the significance of the platinum-free-interval (PFI) is unclear. We evaluated whether an optimal PFI exists in NSCLC for PB re-exposure in contemporary treatment settings. METHODS: We conducted a retrospective cohort study of patients with metastatic NSCLC treated with 1st-line PB chemotherapy with or without immunotherapy. Using multivariable Cox models stratified by treatment strategies, we evaluated whether salvage PB vs. nonPB chemotherapy resulted in superior outcomes and whether this was modulated by the PFI. RESULTS: A total of 751 patients treated with salvage chemotherapy after PB chemoimmunotherapy were identified in 2 treatment strategy cohorts: 3rd-line after sequential chemotherapy and immunotherapy (Sequential Chemo IO, n = 604); 2ndline after chemoimmunotherapy (Concurrent ChemoIO, n = 147). An optimal PFI of 5 and 6 months was identified in the Sequential Chemo IO and Concurrent ChemoIO cohorts, respectively, but there was no overall survival or progression free survival advantage for PB vs. nonPB chemotherapy in long or short PFI groups. CONCLUSION: An optimal PFI was identified in this contemporary NSCLC cohort treated with two common immunotherapy-containing treatment approaches, but PFI threshold did not predict benefit from platinum re-exposure as it has in other malignancies.
Authors: Corey J Langer; Shirish M Gadgeel; Hossein Borghaei; Vassiliki A Papadimitrakopoulou; Amita Patnaik; Steven F Powell; Ryan D Gentzler; Renato G Martins; James P Stevenson; Shadia I Jalal; Amit Panwalkar; James Chih-Hsin Yang; Matthew Gubens; Lecia V Sequist; Mark M Awad; Joseph Fiore; Yang Ge; Harry Raftopoulos; Leena Gandhi Journal: Lancet Oncol Date: 2016-10-10 Impact factor: 41.316
Authors: Martin Reck; Delvys Rodríguez-Abreu; Andrew G Robinson; Rina Hui; Tibor Csőszi; Andrea Fülöp; Maya Gottfried; Nir Peled; Ali Tafreshi; Sinead Cuffe; Mary O'Brien; Suman Rao; Katsuyuki Hotta; Melanie A Leiby; Gregory M Lubiniecki; Yue Shentu; Reshma Rangwala; Julie R Brahmer Journal: N Engl J Med Date: 2016-10-08 Impact factor: 91.245
Authors: Song Ee Park; Se Hoon Lee; Jin Seok Ahn; Myung-Ju Ahn; Keunchil Park; Jong-Mu Sun Journal: J Thorac Oncol Date: 2017-10-31 Impact factor: 15.609
Authors: Egbert F Smit; Sjaak A Burgers; Bonne Biesma; Hans J M Smit; Pier Eppinga; Anne-Marie C Dingemans; Markus Joerger; Jan H Schellens; Andrew Vincent; Nico van Zandwijk; Harry J M Groen Journal: J Clin Oncol Date: 2009-03-23 Impact factor: 44.544
Authors: Cynthia Huang Bartlett; Jack Mardekian; Matthew James Cotter; Xin Huang; Zhe Zhang; Christina M Parrinello; Ariel Bulua Bourla Journal: PLoS One Date: 2020-04-21 Impact factor: 3.240
Authors: Khurum Khan; Gerard G Hanna; Lynn Campbell; Paula Scullin; Adnan Hussain; Ruth L Eakin; Jonathan McAleese Journal: Chin J Cancer Date: 2013-08-28