Prognostic clinical factors in patients affected by non-small-cell lung cancer receiving Nivolumab
Prognostic clinical factors in patients affected by non-small-cell lung cancer receiving Nivolumab
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DOI：
10.1080/14712598.2020.1724953
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发表时间：
2020-02-08
影响因子：
4.6
通讯作者：
Santini, Daniele
中科院分区：
文献类型：
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作者：
Pantano, Francesco;Russano, Marco;Santini, Daniele
背景：免疫检查点抑制剂从根本上改变了非小细胞肺癌（NSCLC）的治疗格局。目前尚不清楚特定的临床特征是否可以识别出那些比其他患者更能从免疫治疗中受益的患者。本研究的目的是确定接受纳武单抗治疗的 NSCLC 患者中与疾病特异性生存 (DSS)、治疗失败时间 (TTF)、客观缓解 (OR) 和疾病进展 (PD) 相关的临床特征。方法：这是一项对 294 名接受纳武单抗治疗的晚期 NSCLC 患者进行的多中心回顾性研究。结果：在分析的 50 多个变量中，有 5 个变量与 DSS 显着相关：ECOG PS、最大脑转移瘤的大小、转移部位的数量、毒性和恶性胸腔积液。三个变量与 TTF 显着相关：恶性胸腔积液、转移部位数量、肝转移数量。恶性胸腔积液是唯一与 OR 显着相关的变量，也是唯一与研究所有终点相关的变量。结论：本研究确定了 NSCLC 患者接受纳武单抗治疗期间与生存和反应相关的临床特征。恶性胸腔积液与客观反应之间的不利关联是一项具有重要转化意义的新发现。
Background: Immune-checkpoint inhibitors have radically changed the treatment landscape of Non-Small-Cell Lung Cancer (NSCLC). It is still unclear whether specific clinical characteristics might identify those patients benefiting from immunotherapy more than others. The aim of this study was to identify clinical characteristics associated with disease-specific survival (DSS), time-to-treatment failure (TTF), objective responses (OR) and progressive disease (PD) in NSCLC patients treated with Nivolumab. Methods: This was a multicenter retrospective study conducted on 294 patients treated with Nivolumab for advanced NSCLC. Results: Of the more than 50 variables analyzed, five showed a significant correlation with DSS: ECOG PS, size of the biggest brain metastasis, number of metastatic sites, toxicity, and malignant pleural effusion. Three variables significantly correlated with TTF: malignant pleural effusion, number of metastatic sites, number of liver metastases. Malignant pleural effusion was the only variable showing a significant correlation with OR, as well as the only one correlating with all the endpoints of the study. Conclusions: This study identified clinical characteristics associated with survival and response during treatment with Nivolumab in NSCLC patients. The unfavorable association between malignant pleural effusion and objective response is a novel finding with important translational implications.