Immune-Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer With Uncommon Histology
•Efficacy of Immune-checkpoint inhibitors (ICIs) in non-small cell lung cancer with uncommon histology is an unmet need.•Our findings highlight no progression-free survival and overall survival difference compared to common histotypes•Further prospective trials are needed to clarify ICIs role in unc...
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| Veröffentlicht in: | Clinical lung cancer 2022-01, Vol.23 (1), p.e17-e28 |
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| creator | Manglaviti, Sara Brambilla, Marta Signorelli, Diego Ferrara, Roberto Lo Russo, Giuseppe Proto, Claudia Galli, Giulia De Toma, Alessandro Occhipinti, Mario Viscardi, Giuseppe Beninato, Teresa Zattarin, Emma Bini, Marta Lobefaro, Riccardo Massa, Giacomo Bottiglieri, Achille Apollonio, Giulia Sottotetti, Elisa Di Mauro, Rosa Maria Trevisan, Benedetta Ganzinelli, Monica Fabbri, Alessandra de Braud, Filippo G.M. Garassino, Marina Chiara Prelaj, Arsela |
| description | •Efficacy of Immune-checkpoint inhibitors (ICIs) in non-small cell lung cancer with uncommon histology is an unmet need.•Our findings highlight no progression-free survival and overall survival difference compared to common histotypes•Further prospective trials are needed to clarify ICIs role in uncommon histotypes.•Combination of ICIs and chemotherapy should be explored in uncommon histologies with a more aggressive behavior.
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) |
| doi_str_mv | 10.1016/j.cllc.2021.06.013 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2557540331</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1525730421001807</els_id><sourcerecordid>2557540331</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-79bb76ee5eab55f2b728b536e70b83634c2a037cdb8ad2309664d8b0b026ac253</originalsourceid><addsrcrecordid>eNp9kE9P3DAQxa2qVaGUL8AB-dhLUv-JnUTigiIoK63aA6AeOFi2M8t6SezFTpD49jha6LGXmZHmzdO8H0JnlJSUUPlzV9phsCUjjJZEloTyT-iYtrwpiGzJ5zwLJoqak-oIfUtpRwiTnLKv6IhXnFeslcfoYTWOs4ei24J92gfnJ7zyW2fcFGLCzuPL_kV7Cz3-HXxxO-phwB3ksp79I-6WVcR_3bTF996GcQwe37g0hSE8vn5HXzZ6SHD63k_Q_fXVXXdTrP_8WnWX68JyIaeibo2pJYAAbYTYMFOzxgguoSam4ZJXlmnCa9ubRveMk1bKqm8MMTmOtkzwE_Tj4LuP4XmGNKnRJZuf1B7CnBQTohYV4ZxmKTtIbQwpRdiofXSjjq-KErVAVTu1QFULVEWkylDz0fm7_2xG6P-dfFDMgouDAHLKFwdRJetgoeYi2En1wf3P_w0WQ4e9</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2557540331</pqid></control><display><type>article</type><title>Immune-Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer With Uncommon Histology</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Manglaviti, Sara ; Brambilla, Marta ; Signorelli, Diego ; Ferrara, Roberto ; Lo Russo, Giuseppe ; Proto, Claudia ; Galli, Giulia ; De Toma, Alessandro ; Occhipinti, Mario ; Viscardi, Giuseppe ; Beninato, Teresa ; Zattarin, Emma ; Bini, Marta ; Lobefaro, Riccardo ; Massa, Giacomo ; Bottiglieri, Achille ; Apollonio, Giulia ; Sottotetti, Elisa ; Di Mauro, Rosa Maria ; Trevisan, Benedetta ; Ganzinelli, Monica ; Fabbri, Alessandra ; de Braud, Filippo G.M. ; Garassino, Marina Chiara ; Prelaj, Arsela</creator><creatorcontrib>Manglaviti, Sara ; Brambilla, Marta ; Signorelli, Diego ; Ferrara, Roberto ; Lo Russo, Giuseppe ; Proto, Claudia ; Galli, Giulia ; De Toma, Alessandro ; Occhipinti, Mario ; Viscardi, Giuseppe ; Beninato, Teresa ; Zattarin, Emma ; Bini, Marta ; Lobefaro, Riccardo ; Massa, Giacomo ; Bottiglieri, Achille ; Apollonio, Giulia ; Sottotetti, Elisa ; Di Mauro, Rosa Maria ; Trevisan, Benedetta ; Ganzinelli, Monica ; Fabbri, Alessandra ; de Braud, Filippo G.M. ; Garassino, Marina Chiara ; Prelaj, Arsela</creatorcontrib><description>•Efficacy of Immune-checkpoint inhibitors (ICIs) in non-small cell lung cancer with uncommon histology is an unmet need.•Our findings highlight no progression-free survival and overall survival difference compared to common histotypes•Further prospective trials are needed to clarify ICIs role in uncommon histotypes.•Combination of ICIs and chemotherapy should be explored in uncommon histologies with a more aggressive behavior.
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.
ICIs role aNSCLC with UH is still unclear. In this retrospective study conducted in 375 pts – with 79 pts having a UH – no significant difference was found between the UH and CH group treated with ICIs. Given the retrospective nature of this study, further prospective trials are needed to clarify ICIs role in UH patients.</description><identifier>ISSN: 1525-7304</identifier><identifier>EISSN: 1938-0690</identifier><identifier>DOI: 10.1016/j.cllc.2021.06.013</identifier><identifier>PMID: 34334296</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung - drug therapy ; Carcinoma, Non-Small-Cell Lung - pathology ; Female ; Humans ; ICIs ; Immune Checkpoint Inhibitors - pharmacology ; Immunotherapy ; Kaplan-Meier Estimate ; Lung cancer ; Lung Neoplasms - drug therapy ; Lung Neoplasms - pathology ; Male ; Middle Aged ; Proportional Hazards Models ; Rare histology ; Retrospective Studies ; Survival Analysis ; Uncommon NSCLC</subject><ispartof>Clinical lung cancer, 2022-01, Vol.23 (1), p.e17-e28</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-79bb76ee5eab55f2b728b536e70b83634c2a037cdb8ad2309664d8b0b026ac253</citedby><cites>FETCH-LOGICAL-c356t-79bb76ee5eab55f2b728b536e70b83634c2a037cdb8ad2309664d8b0b026ac253</cites><orcidid>0000-0003-4637-9821 ; 0000-0002-4345-3355</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1525730421001807$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34334296$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Manglaviti, Sara</creatorcontrib><creatorcontrib>Brambilla, Marta</creatorcontrib><creatorcontrib>Signorelli, Diego</creatorcontrib><creatorcontrib>Ferrara, Roberto</creatorcontrib><creatorcontrib>Lo Russo, Giuseppe</creatorcontrib><creatorcontrib>Proto, Claudia</creatorcontrib><creatorcontrib>Galli, Giulia</creatorcontrib><creatorcontrib>De Toma, Alessandro</creatorcontrib><creatorcontrib>Occhipinti, Mario</creatorcontrib><creatorcontrib>Viscardi, Giuseppe</creatorcontrib><creatorcontrib>Beninato, Teresa</creatorcontrib><creatorcontrib>Zattarin, Emma</creatorcontrib><creatorcontrib>Bini, Marta</creatorcontrib><creatorcontrib>Lobefaro, Riccardo</creatorcontrib><creatorcontrib>Massa, Giacomo</creatorcontrib><creatorcontrib>Bottiglieri, Achille</creatorcontrib><creatorcontrib>Apollonio, Giulia</creatorcontrib><creatorcontrib>Sottotetti, Elisa</creatorcontrib><creatorcontrib>Di Mauro, Rosa Maria</creatorcontrib><creatorcontrib>Trevisan, Benedetta</creatorcontrib><creatorcontrib>Ganzinelli, Monica</creatorcontrib><creatorcontrib>Fabbri, Alessandra</creatorcontrib><creatorcontrib>de Braud, Filippo G.M.</creatorcontrib><creatorcontrib>Garassino, Marina Chiara</creatorcontrib><creatorcontrib>Prelaj, Arsela</creatorcontrib><title>Immune-Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer With Uncommon Histology</title><title>Clinical lung cancer</title><addtitle>Clin Lung Cancer</addtitle><description>•Efficacy of Immune-checkpoint inhibitors (ICIs) in non-small cell lung cancer with uncommon histology is an unmet need.•Our findings highlight no progression-free survival and overall survival difference compared to common histotypes•Further prospective trials are needed to clarify ICIs role in uncommon histotypes.•Combination of ICIs and chemotherapy should be explored in uncommon histologies with a more aggressive behavior.
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.
ICIs role aNSCLC with UH is still unclear. In this retrospective study conducted in 375 pts – with 79 pts having a UH – no significant difference was found between the UH and CH group treated with ICIs. Given the retrospective nature of this study, further prospective trials are needed to clarify ICIs role in UH patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Non-Small-Cell Lung - drug therapy</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Female</subject><subject>Humans</subject><subject>ICIs</subject><subject>Immune Checkpoint Inhibitors - pharmacology</subject><subject>Immunotherapy</subject><subject>Kaplan-Meier Estimate</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Lung Neoplasms - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Proportional Hazards Models</subject><subject>Rare histology</subject><subject>Retrospective Studies</subject><subject>Survival Analysis</subject><subject>Uncommon NSCLC</subject><issn>1525-7304</issn><issn>1938-0690</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9P3DAQxa2qVaGUL8AB-dhLUv-JnUTigiIoK63aA6AeOFi2M8t6SezFTpD49jha6LGXmZHmzdO8H0JnlJSUUPlzV9phsCUjjJZEloTyT-iYtrwpiGzJ5zwLJoqak-oIfUtpRwiTnLKv6IhXnFeslcfoYTWOs4ei24J92gfnJ7zyW2fcFGLCzuPL_kV7Cz3-HXxxO-phwB3ksp79I-6WVcR_3bTF996GcQwe37g0hSE8vn5HXzZ6SHD63k_Q_fXVXXdTrP_8WnWX68JyIaeibo2pJYAAbYTYMFOzxgguoSam4ZJXlmnCa9ubRveMk1bKqm8MMTmOtkzwE_Tj4LuP4XmGNKnRJZuf1B7CnBQTohYV4ZxmKTtIbQwpRdiofXSjjq-KErVAVTu1QFULVEWkylDz0fm7_2xG6P-dfFDMgouDAHLKFwdRJetgoeYi2En1wf3P_w0WQ4e9</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Manglaviti, Sara</creator><creator>Brambilla, Marta</creator><creator>Signorelli, Diego</creator><creator>Ferrara, Roberto</creator><creator>Lo Russo, Giuseppe</creator><creator>Proto, Claudia</creator><creator>Galli, Giulia</creator><creator>De Toma, Alessandro</creator><creator>Occhipinti, Mario</creator><creator>Viscardi, Giuseppe</creator><creator>Beninato, Teresa</creator><creator>Zattarin, Emma</creator><creator>Bini, Marta</creator><creator>Lobefaro, Riccardo</creator><creator>Massa, Giacomo</creator><creator>Bottiglieri, Achille</creator><creator>Apollonio, Giulia</creator><creator>Sottotetti, Elisa</creator><creator>Di Mauro, Rosa Maria</creator><creator>Trevisan, Benedetta</creator><creator>Ganzinelli, Monica</creator><creator>Fabbri, Alessandra</creator><creator>de Braud, Filippo G.M.</creator><creator>Garassino, Marina Chiara</creator><creator>Prelaj, Arsela</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4637-9821</orcidid><orcidid>https://orcid.org/0000-0002-4345-3355</orcidid></search><sort><creationdate>202201</creationdate><title>Immune-Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer With Uncommon Histology</title><author>Manglaviti, Sara ; Brambilla, Marta ; Signorelli, Diego ; Ferrara, Roberto ; Lo Russo, Giuseppe ; Proto, Claudia ; Galli, Giulia ; De Toma, Alessandro ; Occhipinti, Mario ; Viscardi, Giuseppe ; Beninato, Teresa ; Zattarin, Emma ; Bini, Marta ; Lobefaro, Riccardo ; Massa, Giacomo ; Bottiglieri, Achille ; Apollonio, Giulia ; Sottotetti, Elisa ; Di Mauro, Rosa Maria ; Trevisan, Benedetta ; Ganzinelli, Monica ; Fabbri, Alessandra ; de Braud, Filippo G.M. ; Garassino, Marina Chiara ; Prelaj, Arsela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-79bb76ee5eab55f2b728b536e70b83634c2a037cdb8ad2309664d8b0b026ac253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Non-Small-Cell Lung - drug therapy</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Female</topic><topic>Humans</topic><topic>ICIs</topic><topic>Immune Checkpoint Inhibitors - pharmacology</topic><topic>Immunotherapy</topic><topic>Kaplan-Meier Estimate</topic><topic>Lung cancer</topic><topic>Lung Neoplasms - drug therapy</topic><topic>Lung Neoplasms - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Proportional Hazards Models</topic><topic>Rare histology</topic><topic>Retrospective Studies</topic><topic>Survival Analysis</topic><topic>Uncommon NSCLC</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manglaviti, Sara</creatorcontrib><creatorcontrib>Brambilla, Marta</creatorcontrib><creatorcontrib>Signorelli, Diego</creatorcontrib><creatorcontrib>Ferrara, Roberto</creatorcontrib><creatorcontrib>Lo Russo, Giuseppe</creatorcontrib><creatorcontrib>Proto, Claudia</creatorcontrib><creatorcontrib>Galli, Giulia</creatorcontrib><creatorcontrib>De Toma, Alessandro</creatorcontrib><creatorcontrib>Occhipinti, Mario</creatorcontrib><creatorcontrib>Viscardi, Giuseppe</creatorcontrib><creatorcontrib>Beninato, Teresa</creatorcontrib><creatorcontrib>Zattarin, Emma</creatorcontrib><creatorcontrib>Bini, Marta</creatorcontrib><creatorcontrib>Lobefaro, Riccardo</creatorcontrib><creatorcontrib>Massa, Giacomo</creatorcontrib><creatorcontrib>Bottiglieri, Achille</creatorcontrib><creatorcontrib>Apollonio, Giulia</creatorcontrib><creatorcontrib>Sottotetti, Elisa</creatorcontrib><creatorcontrib>Di Mauro, Rosa Maria</creatorcontrib><creatorcontrib>Trevisan, Benedetta</creatorcontrib><creatorcontrib>Ganzinelli, Monica</creatorcontrib><creatorcontrib>Fabbri, Alessandra</creatorcontrib><creatorcontrib>de Braud, Filippo G.M.</creatorcontrib><creatorcontrib>Garassino, Marina Chiara</creatorcontrib><creatorcontrib>Prelaj, Arsela</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical lung cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manglaviti, Sara</au><au>Brambilla, Marta</au><au>Signorelli, Diego</au><au>Ferrara, Roberto</au><au>Lo Russo, Giuseppe</au><au>Proto, Claudia</au><au>Galli, Giulia</au><au>De Toma, Alessandro</au><au>Occhipinti, Mario</au><au>Viscardi, Giuseppe</au><au>Beninato, Teresa</au><au>Zattarin, Emma</au><au>Bini, Marta</au><au>Lobefaro, Riccardo</au><au>Massa, Giacomo</au><au>Bottiglieri, Achille</au><au>Apollonio, Giulia</au><au>Sottotetti, Elisa</au><au>Di Mauro, Rosa Maria</au><au>Trevisan, Benedetta</au><au>Ganzinelli, Monica</au><au>Fabbri, Alessandra</au><au>de Braud, Filippo G.M.</au><au>Garassino, Marina Chiara</au><au>Prelaj, Arsela</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Immune-Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer With Uncommon Histology</atitle><jtitle>Clinical lung cancer</jtitle><addtitle>Clin Lung Cancer</addtitle><date>2022-01</date><risdate>2022</risdate><volume>23</volume><issue>1</issue><spage>e17</spage><epage>e28</epage><pages>e17-e28</pages><issn>1525-7304</issn><eissn>1938-0690</eissn><abstract>•Efficacy of Immune-checkpoint inhibitors (ICIs) in non-small cell lung cancer with uncommon histology is an unmet need.•Our findings highlight no progression-free survival and overall survival difference compared to common histotypes•Further prospective trials are needed to clarify ICIs role in uncommon histotypes.•Combination of ICIs and chemotherapy should be explored in uncommon histologies with a more aggressive behavior.
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.
ICIs role aNSCLC with UH is still unclear. In this retrospective study conducted in 375 pts – with 79 pts having a UH – no significant difference was found between the UH and CH group treated with ICIs. Given the retrospective nature of this study, further prospective trials are needed to clarify ICIs role in UH patients.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34334296</pmid><doi>10.1016/j.cllc.2021.06.013</doi><orcidid>https://orcid.org/0000-0003-4637-9821</orcidid><orcidid>https://orcid.org/0000-0002-4345-3355</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1525-7304 |
| ispartof | Clinical lung cancer, 2022-01, Vol.23 (1), p.e17-e28 |
| issn | 1525-7304 1938-0690 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2557540331 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Aged Aged, 80 and over Carcinoma, Non-Small-Cell Lung - drug therapy Carcinoma, Non-Small-Cell Lung - pathology Female Humans ICIs Immune Checkpoint Inhibitors - pharmacology Immunotherapy Kaplan-Meier Estimate Lung cancer Lung Neoplasms - drug therapy Lung Neoplasms - pathology Male Middle Aged Proportional Hazards Models Rare histology Retrospective Studies Survival Analysis Uncommon NSCLC |
| title | Immune-Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer With Uncommon Histology |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T13%3A13%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Immune-Checkpoint%20Inhibitors%20in%20Advanced%20Non-Small%20Cell%20Lung%20Cancer%20With%20Uncommon%20Histology&rft.jtitle=Clinical%20lung%20cancer&rft.au=Manglaviti,%20Sara&rft.date=2022-01&rft.volume=23&rft.issue=1&rft.spage=e17&rft.epage=e28&rft.pages=e17-e28&rft.issn=1525-7304&rft.eissn=1938-0690&rft_id=info:doi/10.1016/j.cllc.2021.06.013&rft_dat=%3Cproquest_cross%3E2557540331%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2557540331&rft_id=info:pmid/34334296&rft_els_id=S1525730421001807&rfr_iscdi=true |