Medical Oncology/Lung Unit, San Gerardo Hospital, Monza, Italy
Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy.
Anticancer Res. 2019 Aug;39(8):4265-4271. doi: 10.21873/anticanres.13590.
BACKGROUND/AIM: Brain metastases are an additional challenge in patients with non-small-cell lung cancer (NSCLC) because most chemotherapy agents cannot cross the blood-brain barrier. Nivolumab has demonstrated efficacy in patients with advanced squamous NSCLC, but because patients with central nervous system (CNS) metastases are typically excluded from registration trials, 'field-practice' data are needed.
Patients in the Italian cohort of the Expanded Access Program (EAP) who had CNS metastases at baseline were analyzed.
Thirty-seven patients with CNS metastases received a median of six doses of nivolumab. Three patients (8%) had grade 3-4 adverse events and one patient discontinued due to an adverse event. The objective response rate was 19%. Median overall survival was 5.8 (95% confidence interval=1.9-9.8) months and median progression-free survival was 4.9 (95% confidence interval=2.7-7.1) months.
The safety and efficacy of nivolumab in patients with CNS metastases appear to be similar to those seen in the overall EAP cohort in Italy.
背景/目的:脑转移是非小细胞肺癌(NSCLC)患者面临的另一个挑战,因为大多数化疗药物无法穿过血脑屏障。纳武利尤单抗在晚期鳞状 NSCLC 患者中显示出疗效,但由于中枢神经系统(CNS)转移患者通常被排除在注册试验之外,因此需要“现场实践”数据。
分析了意大利扩展准入计划(EAP)意大利队列中基线时有 CNS 转移的患者。
37 例 CNS 转移患者接受了中位数为六剂纳武利尤单抗治疗。3 名患者(8%)出现 3-4 级不良事件,1 名患者因不良事件停药。客观缓解率为 19%。中位总生存期为 5.8 个月(95%置信区间=1.9-9.8),中位无进展生存期为 4.9 个月(95%置信区间=2.7-7.1)。
纳武利尤单抗在 CNS 转移患者中的安全性和疗效似乎与意大利 EAP 总体队列中的疗效相似。