Agar Camille, Geier Margaux, Léveiller Guillaume, Lamy Régine, Bizec Jean-Louis, Tiercin Marie, Bernier Cyril, Robinet Gilles, Léna Hervé, Ricordel Charles, Corre Romain
Centre Hospitalier Universitaire de Rennes, Service de Pneumologie, Université de Rennes 1, Rennes, France.
Centre Hospitalier Régional Universitaire Morvan, Service d'Oncologie, Université de Bretagne Occidentale, Brest, France.
JTO Clin Res Rep. 2020 Dec 10;2(4):100129. doi: 10.1016/j.jtocrr.2020.100129. eCollection 2021 Apr.
The optimal management of large cell neuroendocrine cancer of the lung (LCNEC) is unclear, and data regarding anti-programmed cell death protein 1 (PD-1) antibodies are scarce. This study reports the clinical efficacy of a PD-1 inhibitor in patients with advanced LCNEC.
All patients with stage III to IV LCNEC treated with at least one previous cycle of chemotherapy between January 1, 2015 and December 31, 2018 were reviewed retrospectively. Patients were divided into two groups depending on their exposure to nivolumab as second-line treatment or beyond. The primary objective was to assess nivolumab's efficacy.
A total of 51 patients with advanced LCNEC from eight centers were analyzed, including 17 who received nivolumab. The PD-1 inhibitor was used as second-line treatment in 77% of cases, with a median number of eight doses (range: 1-62). After nivolumab treatment, the median overall survival was 12.1 months (95% confidence interval [CI]: 7.10-14.20). The objective response rate was 29.4% (95% CI: 10.3-56.0), and median progression-free survival was 3.9 months (95% CI: 1.68-7.17). The programmed death-ligand 1 status was unknown. There was no difference in the efficacy of first-line chemotherapy; the objective response rate was 23.5% (n = four of 17) in the nivolumab group versus 32.4% (n = 11 of 34) in the conventional treatment group, and progression-free survival was 3.5 months (95% CI: 1.7-4.4) versus 2.1 months (95% CI: 1.4-4.2), respectively.
In a real-world setting, nivolumab seems to be an effective second-line treatment in patients with advanced LCNEC. Large prospective studies in this setting are still required.
肺大细胞神经内分泌癌（LCNEC）的最佳治疗方案尚不清楚，关于抗程序性细胞死亡蛋白1（PD-1）抗体的数据也很稀少。本研究报告了一种PD-1抑制剂在晚期LCNEC患者中的临床疗效。
回顾性分析了2015年1月1日至2018年12月31日期间接受至少一个周期化疗的所有III至IV期LCNEC患者。根据患者是否接受纳武单抗作为二线或更晚期治疗，将患者分为两组。主要目的是评估纳武单抗的疗效。
共分析了来自八个中心的51例晚期LCNEC患者，其中17例接受了纳武单抗治疗。77%的病例中，PD-1抑制剂被用作二线治疗，中位剂量为8剂（范围：1-62）。纳武单抗治疗后，中位总生存期为12.1个月（95%置信区间[CI]：7.10-14.20）。客观缓解率为29.4%（95%CI：10.3-56.0），中位无进展生存期为3.9个月（95%CI：1.68-7.17）。程序性死亡配体1状态未知。一线化疗的疗效无差异；纳武单抗组的客观缓解率为23.5%（17例中有4例），而传统治疗组为32.4%（34例中有11例），无进展生存期分别为3.5个月（95%CI：1.7-4.4）和2.1个月（95%CI：1.4-4.2）。
在现实世界中，纳武单抗似乎是晚期LCNEC患者有效的二线治疗药物。在这种情况下，仍需要进行大型前瞻性研究。
