Anti-PD-1/L1 plus anti-angiogenesis therapy as second-line or later treatment in advanced lung adenocarcinoma
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ORIGINAL ARTICLE – CLINICAL ONCOLOGY
Anti‑PD‑1/L1 plus anti‑angiogenesis therapy as second‑line or later treatment in advanced lung adenocarcinoma Di Huang1,2 · Pengfei Cui2,3 · Ziwei Huang1,2 · Zhaozhen Wu1,2 · Haitao Tao2 · Sujie Zhang2 · Rong Xiang1 · Yi Hu1,2 Received: 20 May 2020 / Accepted: 1 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Anti-programmed cell death protein 1 or its ligand (anti-PD-1/L1) monotherapy has become the standard secondline treatment in advanced lung adenocarcinoma. However, the strategy treatment of anti-PD-1/L1 plus anti-angiogenesis therapy has not been evaluated. We conducted this retrospective study to assess the efficacy and safety of anti-PD-1/L1 plus anti-angiogenesis therapy in patients with advanced lung adenocarcinoma in the second-line or later setting. Methods Patients with advanced lung adenocarcinoma who received anti-PD-1/L1 plus anti-angiogenesis therapy or antiPD-1/L1 monotherapy in the second-line or later treatment from March 2015 to May 2019 in PLA General Hospital were retrospectively analyzed. The progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety were assessed. Multivariate analyses of PFS and OS were performed with Cox proportional hazard regression models. Results Seventy-four patients were included in our study. Twenty-five patients were treated with anti-PD-1/L1 plus antiangiogenesis therapy, and forty-nine patients were treated with anti-PD-1/L1 monotherapy. The disease control rate (DCR) was higher in the anti-PD-1/L1 plus anti-angiogenesis group than in the anti-PD-1/L1 monotherapy group (92.0% vs. 46.9%, P = 0.0004). The median progression-free survival (PFS) was 5.1 months vs. 2.0 months (HR 0.551 [95% confidence interval 0.337–0.902], P = 0.002) and median overall survival (OS) was 14.3 months vs. 8.4 months (HR 0.549 [95% CI 0.305–0.990], P = 0.046), respectively. Multivariate Cox proportional hazard regression models showed that anti-PD-1/L1 plus anti-angiogenesis group had prolonged PFS (HR 0.541 [95% CI 0.298–0.981], P = 0.033). The incidences of grade 3/4 adverse events were 12% (3/25) in anti-PD-1/L1 plus anti-angiogenesis group and 6% (3/49) in anti-PD-1/L1 monotherapy group. Conclusion Compared with anti-PD-1/L1 monotherapy, anti-PD-1/L1 plus anti-angiogenesis therapy could significantly improve the clinical response and bring longer PFS and OS in patients with advanced lung adenocarcinoma who had failed first-line or later treatment. Further prospective studies are needed to validate our findings. Keywords Anti-PD-1 therapy · Anti-PD-L1 therapy · Anti-angiogenesis therapy · Lung adenocarcinoma
Introduction Non-small lung cancer (NSCLC) accounts for approximately 80% of lung cancer, which is the leading cause of cancer deaths worldwide (Siegel et al. 2020). Lung adenocarcinoma Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00432-020-03380-x) contains supplementary
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