Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
BMC Cancer. 2021 Jun 26;21(1):731. doi: 10.1186/s12885-021-08472-6.
A primary pulmonary invasive mucinous adenocarcinoma (IMA) is a rare subtype of invasive adenocarcinoma of the lung. The prognosis of advanced IMA depending on chemotherapy regimen has not been fully investigated. Here, we compared the clinical outcomes of patients with advanced IMA treated with different palliative chemotherapies that included novel therapeutics.
This single-center retrospective study included a total of 79 patients diagnosed with IMA and treated with palliative chemotherapy. The primary outcome was the comparison of overall survival according to palliative chemotherapy type. Risk factors associated with death were evaluated as a secondary outcome.
The study cohort of 79 patients comprised 27 progressive or recurrent cases and 52 initial metastatic patients. Thirteen patients (16.5%) received targeted therapy and 18 cases (22.8%) received immunotherapy. When we compared the survival outcomes of the different treatment regimens, patients with IMA treated by immunotherapy (undefined vs. non-immunotherapy 17.0 months, p < 0.001) had better overall survival rates. However, there was no difference in the prognosis between the cases treated with a targeted therapy (35.6 vs. non-targeted therapy 17.0 months, p = 0.211). None of the conventional regimens produced a better outcome. By multivariable analysis, immunotherapy (HR 0.28; 95% CI 0.11-0.74; P = 0.008) was found to be an independent prognostic factor for death.
This study suggests that immunotherapy for patients with advanced IMA may provide favorable outcomes than other chemotherapy options.
原发性肺浸润性黏液腺癌（IMA）是一种罕见的肺浸润性腺癌亚型。关于化疗方案治疗晚期 IMA 的预后尚未得到充分研究。在这里，我们比较了接受包括新型治疗药物在内的不同姑息性化疗的晚期 IMA 患者的临床结局。
这项单中心回顾性研究共纳入 79 例诊断为 IMA 并接受姑息性化疗的患者。主要结局是根据姑息性化疗类型比较总生存期。将与死亡相关的危险因素评估为次要结局。
研究队列包括 79 例患者，其中 27 例为进展或复发病例，52 例为初始转移性患者。13 例（16.5%）接受了靶向治疗，18 例（22.8%）接受了免疫治疗。当我们比较不同治疗方案的生存结局时，接受免疫治疗的 IMA 患者（未定义 vs. 非免疫治疗 17.0 个月，p<0.001）的总生存率更高。然而，接受靶向治疗的病例（35.6 vs. 非靶向治疗 17.0 个月，p=0.211）的预后无差异。常规方案均未产生更好的结果。多变量分析显示，免疫治疗（HR 0.28；95%CI 0.11-0.74；P=0.008）是死亡的独立预后因素。
本研究表明，免疫疗法可能为晚期 IMA 患者提供比其他化疗方案更有利的结果。
