Efficacy and safety of immuno-chemotherapy in patients with advanced non-small-cell lung cancer harboring oncogenic mutations: a multicenter retrospective study.

Abstract

PURPOSE:

The effect of immuno-chemotherapy on patients with advanced non-small-cell lung cancer (NSCLC) harboring oncogenic mutations remains poorly understood. This study aimed to characterize the efficacy of immuno-chemotherapy and determine the optimal treatment strategy for such patients.

METHODS:

We conducted this retrospective cohort study on patients with NSCLC harboring oncogenic driver alterations and treated with an immune checkpoint inhibitor combined with chemotherapy at five institutions. The clinical characteristics and outcomes of immuno-chemotherapy for NSCLC with oncogenic mutations in a real-world setting were analyzed.

RESULTS:

Among 846 patients diagnosed with advanced or recurrent NSCLC between April 2017 and April 2021, 43 patients with oncogenic mutations were treated with immuno-chemotherapy. The median age of patients was 68 (range 44-78) years; 42% of patients never smoked, and adenocarcinoma was the most common histology (95%). In patients with KRAS mutations (n = 10) or PD-L1 expression of 50% or greater (n = 10), the disease control rate was 100%. The median progression-free survival (PFS) was 5.4, 6.3, and 8.9 months in patients harboring mutations in EGFR, KRAS, and other genes, respectively (P = 0.22). Patients with PD-L1 expression of 50% or greater had significantly longer median PFS than patients with PD-L1 expression of less than 50% (16.4 vs. 5.1 months; P = 0.001). Two patients experienced grade 3 immuno-related adverse events.

CONCLUSION:

Immuno-chemotherapy has a clinical benefit and is safe for patients with oncogenic mutations. Notably, patients with PD-L1 expression of 50% or more experience greater benefit from immuno-chemotherapy than those with PD-L1 expression of less than 50%.

• Authors: Tae Hata, Chikara Sakaguchi, Keita Hirano, Hiroshi Kobe, Masaki Ishida, Takayuki Nakano, Yusuke Tachibana, Nobuyo Tamiya, Shinsuke Shiotsu, Takayuki Takeda, Tadaaki Yamada, Toshihide Yokoyama, Michiko Tsuchiya, Yukio Nagasaka
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 149 Issue 6 Pg. 2475-2482 (Jun 2023) ISSN: 1432-1335 [Electronic] Germany
• PMID: 35737092 (Publication Type: Multicenter Study, Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• B7-H1 Antigen
• Proto-Oncogene Proteins p21(ras)

Topics

• Humans
• Adult
• Middle Aged
• Aged
• Carcinoma, Non-Small-Cell Lung (drug therapy, genetics, pathology)
• Lung Neoplasms (drug therapy, genetics, pathology)
• B7-H1 Antigen
• Retrospective Studies
• Proto-Oncogene Proteins p21(ras) (genetics)
• Neoplasm Recurrence, Local
• Mutation