Nationwide survival benefit after implementation of first-line immunotherapy for patients with advanced nsclc—real world efficacy

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Mette T. Mouritzen
  • Andreas Carus
  • Morten Ladekarl
  • Peter Meldgaard
  • Anders W.M. Nielsen
  • Anna Livbjerg
  • Jacob W. Larsen
  • Halla Skuladottir
  • Charlotte Kristiansen
  • Kim Wedervang
  • Tine Schytte
  • Karin H. Hansen
  • Jakob Lauritsen
  • Jon L. Andersen
  • Johanna M.C. Frary
  • Lars B. Drivsholm
  • Charles Vesteghem
  • Heidi S. Christensen
  • Birgitte Bjørnhart
  • Mette Pøhl

Background The selection of patients with non-small cell lung cancer (NSCLC) for immune checkpoint inhibitor (ICI) treatment remains challenging. This real-world study aimed to compare the overall survival (OS) before and after the implementation of ICIs, to identify OS prognostic factors, and to assess treatment data in first-line (1L) ICI-treated patients without epidermal growth factor receptor mutation or anaplastic lymphoma kinase translocation. Methods Data from the Danish NSCLC population initiated with 1L palliative antineoplastic treatment from 1 January 2013 to 1 October 2018, were extracted from the Danish Lung Cancer Registry (DLCR). Long-term survival and median OS pre-and post-approval of 1L ICI were compared. From electronic health records, additional clinical and treatment data were obtained for ICI-treated patients from 1 March 2017 to 1 October 2018. Results The OS was significantly improved in the DLCR post-approval cohort (n = 2055) compared to the pre-approval cohort (n = 1658). The 3-year OS rates were 18% (95% CI 15.6–20.0) and 6% (95% CI 5.1–7.4), respectively. On multivariable Cox regression, bone (HR = 1.63) and liver metastases (HR = 1.47), performance status (PS) 1 (HR = 1.86), and PS ≥ 2 (HR = 2.19) were significantly associated with poor OS in ICI-treated patients. Conclusion OS significantly improved in patients with advanced NSCLC after ICI implementation in Denmark. In ICI-treated patients, PS ≥ 1, and bone and liver metastases were associated with a worse prognosis.

OriginalsprogEngelsk
Artikelnummer4846
TidsskriftCancers
Vol/bind13
Udgave nummer19
ISSN2072-6694
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
Conflicts of Interest: The funding sources were not involved in the study design, collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit the article for publication. GF Persson: Advisory board Roche, Astra Zeneca, BMS, MSD, Takeda, Pfizer. Congress travels with Roche, Astra Zeneca, BMS, MSD, Takeda, Pierre Fabre. Research grants from Varian Medical Systems. M Pøhl: Honoraria for lectures and consultancy from AstraZeneca, BMS, MSD, Pfizer, Roche. SW Langer: Advisory board MSD, Roche, Pfizer. The remaining authors declare no conflict of interest.

Funding Information:
Funding: This research was funded by the Danish Health Authority’s ‘Cancer Immunotherapy Research Grant’ (grant number 05-0400-44) and the Medical Fund of the Danish Regions (2 December 2019).

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

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