First-line pembrolizumab in patients with advanced non-small cell lung cancer and high PD-L1 expression : real-world data from a Spanish multicenter study
Piedra, Aida (Universitat Autònoma de Barcelona. Departament de Medicina)
Martinez-Recio, Sergio (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Hernández, Ainhoa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Morán, Teresa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Arriola, Edurne (Hospital del Mar (Barcelona, Catalunya))
Recuero-Borau, Jordi (Hospital del Mar (Barcelona, Catalunya))
Cobo, Manuel (Hospital Regional Universitario Virgen de la Victoria (IBIMA))
Cordeiro, P. (Complejo Hospitalario Universitario de A Coruña)
Mosquera, J. (Complejo Hospitalario Universitario de A Coruña)
Fernández, M. (Complejo Hospitalario Universitario de A Coruña)
Del Rosario García-Campelo, María (Complejo Hospitalario Universitario de A Coruña)
Calles, A. (Hospital General Universitario Gregorio Marañón)
Álvarez, R. (Hospital General Universitario Gregorio Marañón)
Zapata-García, M. (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Isla, Dolores (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Callejo, Ana (Vall d'Hebron Institut d'Oncologia)
Iranzo, Patricia (Vall d'Hebron Institut d'Oncologia)
Serra, Jorgina (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Barba Joaquin, Andrés (Institut de Recerca Sant Pau)
Sullivan, Ivana (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Felip, Enriqueta (Vall d'Hebron Institut d'Oncologia)
Majem, Margarita (Institut de Recerca Sant Pau)

Data:	2024
Resum:	Introduction: Pembrolizumab stands as a first-line option for patients with advanced non-small cell lung cancer (NSCLC) and high programmed death-ligand 1 (PD-L1) expression (PD-L1 ≥50%). Several factors such as antibiotic exposure, low body mass index (BMI), certain metastatic location or poor performance status may influence outcomes. Methods: We conducted a multicenter retrospective analysis in a cohort of patients with advanced high PD-L1 expression NSCLC treated with first-line pembrolizumab in clinical practice. We sought to evaluate clinical outcomes according to several factors. Results: Among the 494 included patients, median age was 67. 29 years, 77% were male, 54% and 38% were former or current smokers, respectively; 84% had an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0-1, and 48% had a BMI of <25. 32% of patients had bone metastases, 32% brain metastases and 16% liver metastases. 35% of patients had exposure to antibiotics (AB), 44% to corticosteroids and 62% to proton pump inhibitors (PPi). With a median follow-up of 14. 3 months, the median overall survival (OS) and progression-free survival (PFS) were 15. 9m (95% CI 13. 1 to 18. 8) and 9. 9m (95% CI 7. 7 to 12. 1), and the overall response rate (ORR) was 43%. After univariate analysis, median OS in patients with ECOG-PS 0 vs. 1 vs. 2 was 36. 7m vs. 14. 8m vs. 2. 7m (p<0. 001). Median OS in patients who received treatment with corticosteroids vs. patients without exposure was 11. 4m vs. 22. 3m (p<0. 001). After multivariate analysis, corticosteroid exposure (HR 1. 41) and ECOG-PS (HR 2. 40) maintained a prognostic impact. Discussion: First-line pembrolizumab outcomes in advanced high PD-L1 expression NSCLC patients could be negatively influenced by corticosteroid exposure or poor ECOG-PS.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	First-line ; High PD-L1 expression ; Immune check-point inhibitors ; Non-small cell lung cancer ; Pembrolizumab ; Predictive factors
Publicat a:	Frontiers in Oncology, Vol. 14 (2024) , p. 1510278, ISSN 2234-943X

DOI: 10.3389/fonc.2024.1510278
PMID: 39741981

11 p, 942.1 KB

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