1. Immune-Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer With Uncommon Histology
- Author
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Emma Zattarin, Giuseppe Viscardi, Elisa Sottotetti, A. Prelaj, Marta Brambilla, Giulia Galli, Riccardo Lobefaro, Monica Ganzinelli, Claudia Proto, Roberto Ferrara, Rosa Maria Di Mauro, Sara Manglaviti, Diego Signorelli, Marta Bini, Mario Occhipinti, Giuseppe Lo Russo, Giulia Apollonio, Giacomo Massa, Teresa Beninato, Filippo de Braud, Alessandra Fabbri, A. Bottiglieri, M.C. Garassino, Alessandro De Toma, and Benedetta Trevisan
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Adenosquamous carcinoma ,medicine.medical_treatment ,Population ,Uncommon NSCLC ,Kaplan-Meier Estimate ,Gastroenterology ,Internal medicine ,Carcinoma, Non-Small-Cell Lung ,medicine ,80 and over ,Humans ,ICIs ,education ,Sarcomatoid carcinoma ,Lung cancer ,Non-Small-Cell Lung ,Immune Checkpoint Inhibitors ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,business.industry ,Not Otherwise Specified ,Carcinoma ,Histology ,Immunotherapy ,Middle Aged ,medicine.disease ,Survival Analysis ,immunotherapy ,lung cancer ,rare histology ,uncommon NSCLC ,Rare histology ,Oncology ,Adenocarcinoma ,Female ,business - Abstract
Immune-checkpoint inhibitors (ICIs) have significantly improved outcome of advanced non-small cell lung cancer (aNSCLC) patients. However, their efficacy remains uncertain in uncommon histologies (UH).Data from ICI treated aNSCLC patients (April,2013-January,2021) in one Institution were retrospectively collected. Univariate and multivariate survival analyses were estimated by Kaplan-Meier and Cox proportional hazards regression model, respectively. Objective response rate (ORR) and disease control rate (DCR) were assessed.Of 375 patients, 79 (21.1%) had UH: 19 (24.1%) sarcomatoid carcinoma, 15 (19.0%) mucinous adenocarcinoma, 10 (12.6%) enteric adenocarcinoma, 8 (10.1%) adenocarcinoma not otherwise specified, 7 (8.9%) large-cell neuroendocrine carcinoma, 6 (7.6%) mixed histology non-adenosquamous, 5 (6.3%) adenosquamous carcinoma, 9 (11.4%) other UH. In UH group, programmed death-ligand 1 (PD-L1)1%, 1-49%, ≥50% and unknown expression were reported in 27.8%, 22.8%, 31.7% and 17.7% patients respectively and ICI was the second/further-line in the majority of patients. After a median follow-up of 35.64 months (m), median progression-free survival (mPFS) was 2.5 m in UH [95% CI 2.2-2.9 m] versus (vs.) 2.7 m in CH [95% CI 2.3-3.2 m, P-value = .584]; median overall survival (mOS) was 8.8 m [95% CI 4.9-12.6 m] vs. 9.7 m [95% CI 8.0-11.3 m, P-value = .653]. At multivariate analyses only ECOG PS was a confirmed prognostic factor in UH. ORR and DCR were 25.3% and 40.5% in UH vs. 21.6% and 49.5% in CH [P-value = .493 and .155 respectively].No significant differences were detected between UH and CH groups. Prospective trials are needed to understand ICIs role in UH population.
- Published
- 2022