Efficacy of PD‐1/PD‐L1 inhibitors in patients with non‐small cell lung cancer and brain metastases: A real‐world retrospective study in China

Abstract Background There is only limited knowledge of the treatment responses and clinical outcomes of immune checkpoint inhibitors (ICIs) in driver gene‐negative non‐small cell lung cancer (NSCLC) patients with brain metastases (BM). This study aims to assess the efficacy of immunotherapy in these...

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Autores principales:	Jiamin Sheng, Hui Li, Xiaoqing Yu, Sizhe Yu, Kaiyan Chen, Guoqiang Pan, Mingying Xie, Na Li, Zichao Zhou, Yun Fan
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	brain metastases efficacy non‐small cell lung cancer PD‐1/PD‐L1 inhibitors Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/8b84efb8272d4cd7ac8a2e3adc9d5dae
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spelling	oai:doaj.org-article:8b84efb8272d4cd7ac8a2e3adc9d5dae2021-11-14T23:28:25ZEfficacy of PD‐1/PD‐L1 inhibitors in patients with non‐small cell lung cancer and brain metastases: A real‐world retrospective study in China1759-77141759-770610.1111/1759-7714.14171https://doaj.org/article/8b84efb8272d4cd7ac8a2e3adc9d5dae2021-11-01T00:00:00Zhttps://doi.org/10.1111/1759-7714.14171https://doaj.org/toc/1759-7706https://doaj.org/toc/1759-7714Abstract Background There is only limited knowledge of the treatment responses and clinical outcomes of immune checkpoint inhibitors (ICIs) in driver gene‐negative non‐small cell lung cancer (NSCLC) patients with brain metastases (BM). This study aims to assess the efficacy of immunotherapy in these patients in a real world setting. Methods NSCLC‐BM patients without driver gene mutations who received ICIs were retrospectively identified between July 2017 and December 2019. The primary observation endpoint was intracranial objective response rate (iORR), and secondary objectives were objective response rate (ORR), intracranial and systemic progression‐free survival (iPFS, PFS), and overall survival (OS). Results We reviewed 1578 patients with lung cancer and BM. According to the exclusion criteria, 41 patients were finally enrolled. Among these 41 patients, iORR was 36.6% (95% confidence interval [CI] = 21.2%–52.0%), whereas iPFS was 6.8 (95% CI = 3.32–10.35) months. Additionally, ORR, PFS, and OS were 24.4% (95% CI = 10.7%–38.1%), 6.2 (95% CI = 4.57–7.83) months and 13.7 (95% CI = 11.20–16.26) months, respectively. ICIs combined with concurrent radiotherapy group exhibited preferred iORR (p = 0.030) compared with no radiotherapy group, and ICIs plus chemotherapy showed improved OS (p = 0.024) compared to ICI monotherapy. Moreover, the lines of ICI treatment ≥2 (p = 0.005) and derived neutrophil‐to‐lymphocyte ratio (dNLR) ≥3 (p = 0.010) were independently negative factors for OS. Conclusion In NSCLC‐BMs patients lacking driver genes, ICIs exhibited an effective drug regime. A combination of ICIs with concurrent radiotherapy showed a better intracranial response, whereas ICIs plus chemotherapy were associated with superior OS.Jiamin ShengHui LiXiaoqing YuSizhe YuKaiyan ChenGuoqiang PanMingying XieNa LiZichao ZhouYun FanWileyarticlebrain metastasesefficacynon‐small cell lung cancerPD‐1/PD‐L1 inhibitorsNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENThoracic Cancer, Vol 12, Iss 22, Pp 3019-3031 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	brain metastases efficacy non‐small cell lung cancer PD‐1/PD‐L1 inhibitors Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	brain metastases efficacy non‐small cell lung cancer PD‐1/PD‐L1 inhibitors Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Jiamin Sheng Hui Li Xiaoqing Yu Sizhe Yu Kaiyan Chen Guoqiang Pan Mingying Xie Na Li Zichao Zhou Yun Fan Efficacy of PD‐1/PD‐L1 inhibitors in patients with non‐small cell lung cancer and brain metastases: A real‐world retrospective study in China
description	Abstract Background There is only limited knowledge of the treatment responses and clinical outcomes of immune checkpoint inhibitors (ICIs) in driver gene‐negative non‐small cell lung cancer (NSCLC) patients with brain metastases (BM). This study aims to assess the efficacy of immunotherapy in these patients in a real world setting. Methods NSCLC‐BM patients without driver gene mutations who received ICIs were retrospectively identified between July 2017 and December 2019. The primary observation endpoint was intracranial objective response rate (iORR), and secondary objectives were objective response rate (ORR), intracranial and systemic progression‐free survival (iPFS, PFS), and overall survival (OS). Results We reviewed 1578 patients with lung cancer and BM. According to the exclusion criteria, 41 patients were finally enrolled. Among these 41 patients, iORR was 36.6% (95% confidence interval [CI] = 21.2%–52.0%), whereas iPFS was 6.8 (95% CI = 3.32–10.35) months. Additionally, ORR, PFS, and OS were 24.4% (95% CI = 10.7%–38.1%), 6.2 (95% CI = 4.57–7.83) months and 13.7 (95% CI = 11.20–16.26) months, respectively. ICIs combined with concurrent radiotherapy group exhibited preferred iORR (p = 0.030) compared with no radiotherapy group, and ICIs plus chemotherapy showed improved OS (p = 0.024) compared to ICI monotherapy. Moreover, the lines of ICI treatment ≥2 (p = 0.005) and derived neutrophil‐to‐lymphocyte ratio (dNLR) ≥3 (p = 0.010) were independently negative factors for OS. Conclusion In NSCLC‐BMs patients lacking driver genes, ICIs exhibited an effective drug regime. A combination of ICIs with concurrent radiotherapy showed a better intracranial response, whereas ICIs plus chemotherapy were associated with superior OS.
format	article
author	Jiamin Sheng Hui Li Xiaoqing Yu Sizhe Yu Kaiyan Chen Guoqiang Pan Mingying Xie Na Li Zichao Zhou Yun Fan
author_facet	Jiamin Sheng Hui Li Xiaoqing Yu Sizhe Yu Kaiyan Chen Guoqiang Pan Mingying Xie Na Li Zichao Zhou Yun Fan
author_sort	Jiamin Sheng
title	Efficacy of PD‐1/PD‐L1 inhibitors in patients with non‐small cell lung cancer and brain metastases: A real‐world retrospective study in China
title_short	Efficacy of PD‐1/PD‐L1 inhibitors in patients with non‐small cell lung cancer and brain metastases: A real‐world retrospective study in China
title_full	Efficacy of PD‐1/PD‐L1 inhibitors in patients with non‐small cell lung cancer and brain metastases: A real‐world retrospective study in China
title_fullStr	Efficacy of PD‐1/PD‐L1 inhibitors in patients with non‐small cell lung cancer and brain metastases: A real‐world retrospective study in China
title_full_unstemmed	Efficacy of PD‐1/PD‐L1 inhibitors in patients with non‐small cell lung cancer and brain metastases: A real‐world retrospective study in China
title_sort	efficacy of pd‐1/pd‐l1 inhibitors in patients with non‐small cell lung cancer and brain metastases: a real‐world retrospective study in china
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/8b84efb8272d4cd7ac8a2e3adc9d5dae
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Efficacy of PD‐1/PD‐L1 inhibitors in patients with non‐small cell lung cancer and brain metastases: A real‐world retrospective study in China

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