Bouhlel Linda, Doyen Jérôme, Chamorey Emmanuel, Poudenx Michel, Ilie Marius, Gal Jocelyn, Guigay Joël, Benzaquen Jonathan, Marquette Charles-Hugo, Berthet Jean-Philippe, Mouroux Jérôme, Schiappa Renaud, Padovani Bernard, Hofman Paul, Otto Josiane
University Côte d'Azur, CHU of Nice, FHU OncoAge, department of pulmonary medicine and oncology, 30, voie Romaine, 06000 Nice, France.
University of Côte d'Azur, Centre Antoine-Lacassagne, Fédération Claude-Lalanne, department of radiation oncology, 33, avenue de Valombrose, 06189 Nice, France.
Bull Cancer. 2020 Sep;107(9):946-958. doi: 10.1016/j.bulcan.2020.04.019. Epub 2020 Jul 6.
It has been found that occurrence of immune-related adverse events (irAEs) is associated with outcome in the treatment of advanced non-small-cell lung cancer (NSCLC) with anti-programmed cell death (PD)-1 or anti-PDL1 agents. Independent correlation with survival was not consistently demonstrated and correlation with the number of toxicities was also not previously described. All patients treated with nivolumab for advanced NSCLC, in the second line setting, were retrospectively reviewed in a single-center from March 2015 to March 2017. Sixty-nine patients were identified. After a median follow-up of 13 months (95% CI: 10.8; 15.3), there were 46 tumor progressions and 37 deaths. The 6-month and one-year progression-free survival (PFS) and overall survival (OS) rates were 29%/61% and 24%/49%, respectively. Thirty-one patients (44.9%) presented irAEs. Patients presenting tumor response to previous chemotherapy had a higher rate of irAEs (P=0.01) and a better OS (HR=2, P=0.04). Occurrence of irAEs correlated with OS in multivariate analysis (HR=0.4, 95% CI [0.19; 0.8], P=0.02). The number of irAEs correlated with tumor response, PFS and OS in univariate analysis. Having≥2 irAEs correlated with better outcome compared with one irAE, which correlated with better tumor response and PFS in comparison with 0 irAE, in multivariate analysis. In this study, irAEs was associated with a better outcome in patients treated with nivolumab for advanced NSCLC in the second line setting. Interestingly, the number of irAEs correlated with tumor response and PFS.
已发现免疫相关不良事件（irAE）的发生与晚期非小细胞肺癌（NSCLC）使用抗程序性细胞死亡（PD）-1或抗PDL1药物治疗的结果相关。与生存率的独立相关性未得到一致证实，且与毒性数量的相关性此前也未被描述。对2015年3月至2017年3月在单中心接受纳武单抗治疗晚期NSCLC的所有二线患者进行回顾性研究。共纳入69例患者。中位随访13个月（95%CI：10.8；15.3）后，有46例肿瘤进展和37例死亡。6个月和1年的无进展生存期（PFS）和总生存期（OS）率分别为29%/61%和24%/49%。31例患者（44.9%）出现irAE。对既往化疗有肿瘤反应的患者irAE发生率更高（P=0.01），OS更好（HR=2，P=0.04）。多因素分析中，irAE的发生与OS相关（HR=0.4，95%CI[0.19；0.8]，P=0.02）。单因素分析中，irAE的数量与肿瘤反应、PFS和OS相关。多因素分析中，与1例irAE相比，≥2例irAE与更好的预后相关，与0例irAE相比，1例irAE与更好的肿瘤反应和PFS相关。在本研究中，二线接受纳武单抗治疗的晚期NSCLC患者中，irAE与更好的预后相关。有趣的是，irAE的数量与肿瘤反应和PFS相关。
