Clinical Outcomes for PD-1 Inhibitor Plus Chemotherapy as Second-Line or Later Therapy Compared to PD-1/PD-L1 Inhibitor Alone in Advanced Non-small-cell Lung Cancer.
Clinical Outcomes for PD-1 Inhibitor Plus Chemotherapy as Second-Line or Later Therapy Compared to PD-1/PD-L1 Inhibitor Alone in Advanced Non-small-cell Lung Cancer.
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DOI：
10.3389/fonc.2020.556275
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发表时间：
2020
影响因子：
4.7
通讯作者：
Zhu H
中科院分区：
文献类型：
--
作者：
Zhai X;Jing X;Li J;Tian Y;Xu S;Wang M;Zhu H
程序性死亡-1（PD-1）/程序性死亡配体1（PD-L1）抑制剂单药治疗已被批准作为晚期非小细胞肺癌（NSCLC）的二线或后续治疗。本研究旨在比较PD-1抑制剂联合化疗与PD-1/PD-L1抑制剂单药治疗作为晚期NSCLC二线或后续治疗的临床结局。回顾性收集了接受PD-1/PD-L1抑制剂作为二线或二线后治疗的晚期NSCLC患者的临床数据。根据使用的治疗方式，将患者分配至两组之一：PD-1/PD-L1抑制剂单药治疗组或PD-1抑制剂加化疗联合治疗组。比较两组患者的疾病控制率（DCR）、无进展生存期（PFS）和总生存期（OS）。同时评估了衍生的嗜中性粒细胞与淋巴细胞比率（dNLR）和乳酸脱氢酶（LDH）对预后的影响。2017年4月至2019年10月，本研究共入组84例患者。26例患者（PD-1抑制剂，n = 25; PD-L1抑制剂，n = 1）接受PD-1/PD-L1抑制剂单药治疗，58例患者接受PD-1抑制剂加化疗。所用化疗方案如下：脂质体紫杉醇（n = 15）;白蛋白结合型紫杉醇（n = 12）;多西他赛（n = 9）;培美曲塞（n = 6）;和其他（n = 16）。两组的DCR和OS无显著差异。单药治疗组的PFS长于联合治疗组（mPFS：9.6 vs 4.6个月，P = 0.01）。单因素和多因素分析提示LDH和性别是影响PFS的独立预后因素。在38例患者的二线治疗亚组中，两组之间的OS和PFS无显著差异。在46例接受二线以上治疗的患者亚组中，单药治疗组的PFS较长（mPFS：9.6 vs. 4.2个月，P = 0.01）。单药治疗组和联合治疗组的任何级别不良事件发生率均无显著差异（19.2% vs. 18.9%，P = 1.000）。PD-1抑制剂加化疗组1例患者死于免疫相关性肺炎。PD-1抑制剂联合化疗作为二线或后续治疗的临床结局与PD-1/PD-L1抑制剂单药治疗晚期NSCLC的临床结局相似。
Programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitor monotherapy has been approved as second-line or later therapy in advanced non-small-cell lung cancer (NSCLC). The study aimed to compare the clinical outcomes of PD-1 inhibitor plus chemotherapy with PD-1/PD-L1 inhibitor monotherapy as second-line or later therapy in advanced NSCLC. The clinical data of patients with advanced NSCLC who received PD-1/PD-L1 inhibitors as second-line or later line therapy was retrospectively collected. Patients were assigned to one of the two groups according to the therapeutic modality used: PD-1/PD-L1 inhibitor monotherapy group or PD-1 inhibitor plus chemotherapy combination therapy group. Disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) were evaluated between the two groups. The prognostic effect of the derived neutrophil-to-lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH) on the outcomes was also evaluated. From April 2017 to October 2019, a total of 84 patients were enrolled in the current study. Twenty-six patients (PD-1 inhibitor, n = 25; PD-L1 inhibitor, n = 1) received PD-1/PD-L1 inhibitor monotherapy, and fifty-eight patients received PD-1 inhibitor plus chemotherapy. The chemotherapy regimens used were as follows: liposome paclitaxel (n = 15); nab-paclitaxel (n = 12); docetaxel (n = 9); pemetrexed (n = 6); and others (n = 16). The DCR and OS were not significantly different between the two groups. The PFS of the monotherapy group was longer than that of the combination therapy group (mPFS: 9.6 vs. 4.6 months, P = 0.01). Univariate and multivariate analyses suggested that LDH and sex were independent prognostic factors of PFS. In the second-line therapy subgroup of 38 patients, OS and PFS were not significantly different between the two groups. In the subgroup of 46 patients treated beyond the 2nd line, the monotherapy group had a longer PFS (mPFS: 9.6 vs. 4.2 months, P = 0.01). The incidence of any-grade adverse events was not significantly different between the monotherapy group and the combination therapy group (19.2 vs. 18.9%, P = 1.000). One patient in the PD-1 inhibitor plus chemotherapy group died of immune-related pneumonitis. The clinical outcomes of PD-1 inhibitor plus chemotherapy as second-line or later therapy were similar to those of PD-1/PD-L1 inhibitor alone in advanced NSCLC.
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DOI：
10.1084/jem.20050915
发表时间：
2005-12-19
期刊：
The Journal of experimental medicine
影响因子：
--
作者：
Casares N;Pequignot MO;Tesniere A;Ghiringhelli F;Roux S;Chaput N;Schmitt E;Hamai A;Hervas-Stubbs S;Obeid M;Coutant F;Métivier D;Pichard E;Aucouturier P;Pierron G;Garrido C;Zitvogel L;Kroemer G
通讯作者：
Kroemer G
DOI：
10.1158/1078-0432.ccr-15-3101
发表时间：
2016-09-15
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Gainor JF;Shaw AT;Sequist LV;Fu X;Azzoli CG;Piotrowska Z;Huynh TG;Zhao L;Fulton L;Schultz KR;Howe E;Farago AF;Sullivan RJ;Stone JR;Digumarthy S;Moran T;Hata AN;Yagi Y;Yeap BY;Engelman JA;Mino-Kenudson M
通讯作者：
Mino-Kenudson M
影响因子：
28.4
作者：
Mezquita, Laura;Auclin, Edouard;Besse, Benjamin
通讯作者：
Besse, Benjamin
影响因子：
45.3
作者：
Gadgeel, Shirish;Rodriguez-Abreu, Delvys;Garassino, Marina C.
通讯作者：
Garassino, Marina C.
影响因子：
5.6
作者：
Le, Hanh K.;Graham, Laura;Bear, Harry D.
通讯作者：
Bear, Harry D.