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Pembrolizumab plus chemotherapy-induced pneumonitis in chemo-naïve patients with non-squamous non-small cell lung cancer: A multicentre, retrospective cohort study.
- Source :
-
European Journal of Cancer . Jun2021, Vol. 150, p63-72. 10p. - Publication Year :
- 2021
-
Abstract
- Despite the extensive use of the combination of cytotoxic chemotherapy and programmed cell death protein 1/programmed death-ligand 1 checkpoint inhibitors for cancer treatment, the incidence and characteristics of pneumonitis caused by this combination therapy have not been examined in clinical settings. We conducted a 36-centre, retrospective cohort study in patients with chemo-naïve advanced non-squamous non-small cell lung cancer who received a combination of platinum, pemetrexed and pembrolizumab between December 2018 and June 2019. The study comprised 299 patients. The most frequent grade ≥3 non-hematologic adverse event was pneumonitis. There were 37 patients (12.4%, 95% CI 8.9–16.7) with all-grade pneumonitis and 10 (3.3%, 95% CI 1.6–6.1) with grade ≥3 pneumonitis. Of these, 21 (7.0%, 95% CI 4.4–10.5) and 9 patients (3.0%, 95% CI 1.4–5.6) developed all-grade and grade ≥3 pneumonitis within 90 days after initiating the combination therapy, respectively. The median time to treatment failure and progression-free survival was 5.9 (95% CI 5.0–6.8) and 7.5 (95% CI 6.5–8.7) months, respectively. In the survival analysis after adjusting for immortal time bias, pneumonitis was independently associated with shorter progression-free survival (HR 1.99, 95% CI 1.07–3.69, P = 0.03) and overall survival (HR 3.03, 95% CI 1.12–8.20, P = 0.03). Treatment-related pneumonitis occurred at a higher rate in the real-world population than that reported previously; it led to worse survival outcomes. Pneumonitis requires more attention. Additional studies are required to improve the safety of this combination therapy. UMIN000038084 • Data on pembrolizumab plus chemotherapy-induced pneumonitis are limited. • We conducted a 36-centre, retrospective cohort study. • Treatment-related pneumonitis occurred at a higher rate in real-world settings. • After adjusting for immortal time bias, pneumonitis led to worse survival outcomes. • Our findings indicate that pneumonitis requires the careful attention of clinicians. [ABSTRACT FROM AUTHOR]
- Subjects :
- *LUNG cancer prognosis
*THERAPEUTIC use of monoclonal antibodies
*LUNG cancer
*PNEUMONIA
*RESEARCH
*CONFIDENCE intervals
*ANTINEOPLASTIC agents
*MEDICAL cooperation
*RETROSPECTIVE studies
*CANCER patients
*DESCRIPTIVE statistics
*SURVIVAL analysis (Biometry)
*ODDS ratio
*LONGITUDINAL method
EPITHELIAL cell tumors
Subjects
Details
- Language :
- English
- ISSN :
- 09598049
- Volume :
- 150
- Database :
- Academic Search Index
- Journal :
- European Journal of Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 150388298
- Full Text :
- https://doi.org/10.1016/j.ejca.2021.03.016