Noguchi Susumu, Suminaga Keiichiro, Kaki Takahiro, Kawachi Hiroaki, Fukao Akari, Terashita Satoshi, Horikawa Sadao, Ikeue Tatsuyoshi, Sugita Takakazu
Respiratory Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
Lung Cancer (Auckl). 2020 Jul 12;11:53-57. doi: 10.2147/LCTT.S254146. eCollection 2020.
The effects of immune checkpoint inhibitors have been reported to be linked with immune-related adverse events (irAEs). In patients with advanced non-small-cell lung cancer, who tested positive for programmed death-ligand 1 (PD-L1), pembrolizumab, an immune checkpoint inhibitor can be used as a treatment, and it was found to improve overall survival. However, there are only a few reports on the relationship between the therapeutic effects of pembrolizumab in patients with lung cancer and the irAEs of pembrolizumab. The purpose of this study was to determine the correlation between immune-related adverse events and the effects of pembrolizumab monotherapy in patients with non-small-cell lung cancer.
From February 2017 to August 2019, we conducted a retrospective analysis of the effects of pembrolizumab treatment and immune-related adverse events in 94 patients with non-small-cell lung cancer treated with pembrolizumab only.
In 63 cases, irAEs were observed. The most common irAE was rash. PD-L1 positivity ≥ 50% tended to cause irAEs. The median progression-free survival (PFS) rates with and without irAEs were 371 days (95% CI, 184-NR) and 67 days (95% CI, 51-87 days), respectively. In a multivariate analysis, irAEs and Eastern Cooperative Oncology Group performance status (PS) were the factors related to PFS.
In patients with lung cancer, who were treated with pembrolizumab monotherapy, the development of irAEs was likely indicative of the positive effects of pembrolizumab. This novel finding appears to be useful for clinicians who work with pembrolizumab for lung cancer treatment.
据报道，免疫检查点抑制剂的疗效与免疫相关不良事件（irAE）有关。在程序性死亡配体1（PD-L1）检测呈阳性的晚期非小细胞肺癌患者中，免疫检查点抑制剂帕博利珠单抗可作为一种治疗方法，并且已发现其可改善总生存期。然而，关于帕博利珠单抗在肺癌患者中的治疗效果与帕博利珠单抗的irAE之间关系的报道较少。本研究的目的是确定非小细胞肺癌患者中免疫相关不良事件与帕博利珠单抗单药治疗效果之间的相关性。
2017年2月至2019年8月，我们对仅接受帕博利珠单抗治疗的94例非小细胞肺癌患者的帕博利珠单抗治疗效果和免疫相关不良事件进行了回顾性分析。
63例患者观察到irAE。最常见的irAE是皮疹。PD-L1阳性≥50%倾向于引起irAE。有和无irAE的患者的中位无进展生存期（PFS）分别为371天（95%CI，184-未达到）和67天（95%CI，51-87天）。多因素分析显示，irAE和东部肿瘤协作组体能状态（PS）是与PFS相关的因素。
在接受帕博利珠单抗单药治疗的肺癌患者中，irAE的发生可能表明帕博利珠单抗的积极效果。这一新发现似乎对使用帕博利珠单抗治疗肺癌的临床医生有用。
