1. Non-inferior clinical outcomes of immune checkpoint inhibitors in non-small cell lung cancer patients with interstitial lung disease
- Author
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Kazuhiro Shimaya, Yoshikazu Tsukada, Tsukasa Okamoto, Kazuhito Saitou, Tatsuo Kawahara, Ichirou Natsume, Takaaki Yamashita, Shun Tsuyuki, Masayoshi Kobayashi, Hiroaki Saito, Yasuto Jin, Hiroyuki Sakashita, Akifumi Mochizuki, Yuri Tasaka, Yoshihiro Miyashita, Takayuki Honda, Tomoshige Chiaki, Reiko Taki, Toshiharu Tsutsui, Rie Sakakibara, Yasunari Miyazaki, Haruna Watabe, Naoki Nishiyama, and Takahiro Mitsumura
- Subjects
0301 basic medicine ,Pulmonary and Respiratory Medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Immune checkpoint inhibitors ,Pembrolizumab ,behavioral disciplines and activities ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,medicine ,Humans ,Lung cancer ,Immune Checkpoint Inhibitors ,Retrospective Studies ,Response rate (survey) ,business.industry ,Interstitial lung disease ,respiratory system ,medicine.disease ,Disease control ,respiratory tract diseases ,body regions ,030104 developmental biology ,030220 oncology & carcinogenesis ,Non small cell ,Neoplasm Recurrence, Local ,Nivolumab ,Lung Diseases, Interstitial ,business - Abstract
The efficacy of immune checkpoint inhibitors (ICIs) in non-small-cell lung cancer (NSCLC) patients with pre-existing interstitial lung disease (ILD) is unclear.Retrospective medical data from advanced or recurrent NSCLC patients who were treated with nivolumab or pembrolizumab at ten institutions in Japan between January 2016 and September 2018 were analyzed. Eligible patients were divided into two groups according to the presence of pre-existing ILD.A total of 461 NSCLC patients were enrolled, 412 without ILD (Non-ILD group) and 49 with ILD (ILD group). The response rate (RR) and disease control rate (DCR) of the ILD group were not inferior to those of the Non-ILD group [RR: 49.0 % (24/49) vs. 30.1 % (124/412), P 0.01 and DCR: 69.4 % (34/49) vs. 51.2 % (211/412), P = 0.016, respectively]. Non-inferior outcomes were also observed with respect to progression-free survival (PFS) and overall survival (OS) (median PFS: 5.9 months vs. 3.5 months, P = 0.14 and median OS: 27.8 months vs. 25.2 months, P = 0.74 in the ILD and Non-ILD groups, respectively). Among immune-related adverse effects (irAEs), checkpoint inhibitor pneumonitis (CIP) was more frequently observed among NSCLC patients in the ILD group [30.6 % (15/49) vs. 9.5 % (39/412), P 0.01]. The frequency of irAEs other than CIP and infusion reactions was not significantly different between the ILD group and the Non-ILD group.These results suggest that the clinical outcomes of ICIs are not significantly affected by pre-existing ILD despite the increased frequency of CIP. NSCLC patients with ILD are therefore probable candidates for ICIs.
- Published
- 2021
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