AstraZeneca, Gaithersburg, MD.
Hospital Universitario 12 de Octubre, CNIO, Universidad Complutense & Ciberonc, Madrid, Spain.
Clin Lung Cancer. 2019 Nov;20(6):e601-e608. doi: 10.1016/j.cllc.2019.06.020. Epub 2019 Jun 26.
Two clinical studies (Study 1108 and ATLANTIC) were analyzed to evaluate the prognostic value of baseline liver metastases (LMs) in advanced/metastatic non-small-cell lung cancer patients treated with durvalumab 10 mg/kg every 2 weeks.
A multivariate Cox proportional hazards analysis was conducted; covariates included performance status, tumor stage, histology, sex, age, smoking status, and programmed cell death ligand 1 (PD-L1) status.
In all, 569 patients were included. LMs were present in 31.6% (96/304) of Study 1108 patients and 17.9% (47/263) of ATLANTIC patients. Median overall survival (OS) was shorter in patients with LMs than in those without in both studies. In both studies, LMs were an independent negative prognostic factor for OS and progression-free survival. Objective response rates were also significantly lower. PD-L1 independently predicted benefit across all patients.
Liver metastases were associated with worse outcomes irrespective of PD-L1 status, but PD-L1 status predicted benefit from durvalumab irrespective of LMs.
两项临床研究(研究 1108 和 ATLANTIC)进行了分析,以评估基线肝转移(LM)在接受 durvalumab 10mg/kg 每 2 周治疗的晚期/转移性非小细胞肺癌患者中的预后价值。
进行了多变量 Cox 比例风险分析;协变量包括表现状态、肿瘤分期、组织学、性别、年龄、吸烟状况和程序性死亡配体 1(PD-L1)状态。
共纳入 569 例患者。在研究 1108 患者中,31.6%(96/304)和 ATLANTIC 患者中 17.9%(47/263)存在 LM。在两项研究中,有 LM 的患者的总生存期(OS)均短于无 LM 的患者。在两项研究中,LM 是 OS 和无进展生存期的独立负预后因素。客观缓解率也显著降低。PD-L1 独立预测了所有患者的获益。
无论 PD-L1 状态如何,肝转移与预后不良相关,但 PD-L1 状态预测了 durvalumab 的获益,而与 LM 无关。