Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, 310016 Zhejiang, China.
Department of Respiratory Medicine, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, 310016 Zhejiang, China.
Int Immunopharmacol. 2020 Dec;89(Pt A):107033. doi: 10.1016/j.intimp.2020.107033. Epub 2020 Oct 8.
The synergistic effects of immunotherapy and antiangiogenic therapy in advanced non-small cell lung cancer (NSCLC) have been reported in both preclinical and clinical trials. Herein, we evaluated the preliminary efficacy and safety of combined immunotherapy and antiangiogenic therapy in patients with previously treated advanced NSCLC in a real-world setting.
We conducted a 2-center, retrospective study of previously treated advanced NSCLC patients who received any anti-programmed death-1 antibody combined with antiangiogenic agent between May 2018 and March 2020.
In total, 57 patients were included in this study, and the objective response rate and disease control rate were 19.3% and 63.2%, respectively. The median progression-free survival (PFS) was 4.2 months (95% confidence interval [CI]: 3.2-5.2 months). Bone metastases (odds ratio [OR] not available; P < .01) and ≥ 3 treatment lines (OR 6.8; 95% CI: 1.6-29.6; P < .05) were independent negative predictors of objective response. Additionally, liver metastases (hazard ratio [HR] 3.7; 95% CI: 1.6-8.5; P < 0.01), poor performance status score (PS) (HR 3.4; 95% CI: 1.6-7.5; P < 0.01) and ≥ 3 treatment lines (HR 3.5; 95% CI: 1.7-7.4; P < 0.01) were found to be negative predictors of PFS. Eighty-nine percent of the patients experienced an adverse event.
Metastatic sites (bone and liver), ≥3 treatment lines and poor PS were potential negative predictors of the efficacy of immunotherapy combined with antiangiogenic therapy for treating NSCLC. Further investigations and randomized controlled trials are needed.
免疫疗法和抗血管生成疗法在晚期非小细胞肺癌（NSCLC）的临床前和临床试验中均显示出协同作用。在此，我们评估了免疫疗法联合抗血管生成疗法在真实环境中治疗既往治疗的晚期 NSCLC 患者的初步疗效和安全性。
我们进行了一项 2 中心、回顾性研究，纳入了 2018 年 5 月至 2020 年 3 月期间接受任何抗 PD-1 抗体联合抗血管生成药物治疗的既往治疗的晚期 NSCLC 患者。
共有 57 例患者纳入本研究，客观缓解率和疾病控制率分别为 19.3%和 63.2%。中位无进展生存期（PFS）为 4.2 个月（95%置信区间[CI]：3.2-5.2 个月）。骨转移（比值比[OR]无法获得；P<.01）和≥3 线治疗（OR 6.8；95%CI：1.6-29.6；P<.05）是客观缓解的独立负预测因素。此外，肝转移（HR 3.7；95%CI：1.6-8.5；P<.01）、较差的表现状态评分（PS）（HR 3.4；95%CI：1.6-7.5；P<.01）和≥3 线治疗（HR 3.5；95%CI：1.7-7.4；P<.01）是 PFS 的负预测因素。89%的患者发生了不良事件。
转移部位（骨和肝）、≥3 线治疗和较差的 PS 是免疫疗法联合抗血管生成疗法治疗 NSCLC 疗效的潜在负预测因素。需要进一步的研究和随机对照试验。
