Efficacy of immune checkpoint inhibitor monotherapy for patients with massive non-small-cell lung cancer
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ORIGINAL ARTICLE – CLINICAL ONCOLOGY
Efficacy of immune checkpoint inhibitor monotherapy for patients with massive non‑small‑cell lung cancer Taiki Hakozaki1 · Yukio Hosomi1 · Rui Kitadai1 · Shingo Kitagawa1 · Yusuke Okuma1,2 Received: 13 March 2020 / Accepted: 20 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Baseline tumor size (BTS) and the presence of massive lesions are important for predicting the clinical course of cancer. However, their impact on survival and clinical response in patients with advanced NSCLC undergoing immune checkpoint inhibitor (ICI) treatment has been scarcely investigated. Methods We retrospectively reviewed 294 patients who underwent ICI therapy for advanced or recurrent non-small-cell lung cancer (NSCLC) between January 2016 and July 2019. Results Of these 294 patients, 284 (96.6%) had at least one measurable lesion. Of these, 263 patients treated with ICI monotherapy were included in the analysis. The median total and maximum target lesion diameters were 96.5 mm and 49.1 mm, respectively. Median progression-free survival (PFS) with massive lesions (max BTS > 50 mm, group A) and without massive lesions (max BTS ≤ 50 mm, group B) was 2.5 months (95% CI 1.8–3.7) and 6.7 months (95% CI 5.1–9.7), respectively. Median overall survival (OS) for groups A and B was 9.5 months (95% CI 5.5–12.3) and 20.0 months (95% CI 13.3–32.0), respectively. The multivariate analysis revealed marked associations between the presence of massive lesions and both PFS and OS. Conclusion The presence of massive lesions (max diameters > 50 mm) is an independent prognostic factor in advanced NSCLC treated with ICI monotherapy. Although overall response rates were similar between groups A and B, the disease control rate was significantly poorer for group A. Max BTS might be useful for predicting clinical outcomes for patients undergoing immunotherapy as a parameter reflecting their tumor burden. Keywords Tumor size · Non-small-cell lung cancer · Immune checkpoint inhibitor · Overall survival · Progression-free survival
Introduction Immune checkpoint inhibitors (ICIs), including anti-programmed death-1 (PD-1) antibodies and anti-programmed death-ligand 1 (PD-L1) antibody, are currently approved Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00432-020-03271-1) contains supplementary material, which is available to authorized users. * Yukio Hosomi [email protected] 1
Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3‑18‑22 Honkomagome, Bunkyo, Tokyo 113‑8677, Japan
Department of Thoracic Oncology, National Cancer Center Hospital, 5‑1‑1Tsukiji, Chuo, Tokyo 105‑0045, Japan
2
for unresectable advanced or recurrent non-small-cell lung cancer (NSCLC). Several pivotal clinical trials have demonstrated the clinical benefit [1–4] and revolutionary longlasting response for some patients [5, 6] that these agents present over docetaxel, w
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