Xiao Yi, He Jinyuan, Luo Shaoning, Dong Min, Li Wei, Liu Gaijiao, Chen Hongjie, Yang Xiongwen, Huang Shaohong
Department of Thoracocardiac Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Emergency Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Front Oncol. 2022 Feb 14;12:820302. doi: 10.3389/fonc.2022.820302. eCollection 2022.
Pulmonary lymphoepithelioma-like carcinoma (pLELC) is a rare subtype of lung cancer that is associated with the Epstein-Barr virus in Asia. Due to the lack of prospective studies, the best first-line treatment and survival outcomes remain unclear. Herein, This study investigated the efficacy and safety of different treatment regimens for advanced pLELC. This retrospective study included 68 patients with advanced pLELC from two centers in China. Patients were divided into three groups according to different first-line treatments: chemotherapy (n=49, 72.1%), immunotherapy (n=7, 10.3%), and chemoimmunotherapy (n=12,17.6%). The primary endpoint of this study was the 2-year progression-free survival (PFS) of each group. The results show that the median PFS was 6.9 months (range, 2.3-not estimable) in the chemotherapy group, 11.0 months (range, 2-not estimable) in the immunotherapy group, and 11.8 months (range, 6-not estimable) in the chemoimmunotherapy group. There was a significant difference in 2-year PFS between the chemoimmunotherapy group and the chemotherapy group (hazard ratio, 0.38, 95% confidence interval: 0.18-0.78, log-rank 0.007). The most frequent grade 3-4 adverse event in the chemotherapy and chemoimmunotherapy groups was myelosuppression (10/49 [22.4%] and 4/12 [33.3%], respectively). The most frequent grade 3-4 adverse events in the immunotherapy group were diarrhea (1/7, 14.8%) and hepatotoxicity (1/7, 14.8%). Chemoimmunotherapy had the highest 2-year PFS as a first-line treatment for advanced pLELC compared to chemotherapy and immunotherapy. This study suggests that chemoimmunotherapy may be the best first-line treatment for patients with advanced pLELC.
肺淋巴上皮瘤样癌（pLELC）是肺癌的一种罕见亚型，在亚洲与爱泼斯坦-巴尔病毒有关。由于缺乏前瞻性研究，最佳的一线治疗方案和生存结果仍不明确。在此，本研究调查了不同治疗方案对晚期pLELC的疗效和安全性。这项回顾性研究纳入了来自中国两个中心的68例晚期pLELC患者。根据不同的一线治疗方法，患者被分为三组：化疗组（n = 49，72.1%）、免疫治疗组（n = 7，10.3%）和化疗免疫治疗组（n = 12，17.6%）。本研究的主要终点是每组的2年无进展生存期（PFS）。结果显示，化疗组的中位PFS为6.9个月（范围：2.3 - 不可估计），免疫治疗组为11.0个月（范围：2 - 不可估计），化疗免疫治疗组为11.8个月（范围：6 - 不可估计）。化疗免疫治疗组和化疗组之间的2年PFS存在显著差异（风险比，0.38，95%置信区间：0.18 - 0.78，对数秩检验P = 0.007）。化疗组和化疗免疫治疗组中最常见的3 - 4级不良事件是骨髓抑制（分别为10/49 [22.4%]和4/12 [33.3%]）。免疫治疗组中最常见的3 - 4级不良事件是腹泻（1/7，14.8%）和肝毒性（1/7，14.8%）。与化疗和免疫治疗相比，化疗免疫治疗作为晚期pLELC的一线治疗具有最高的2年PFS。本研究表明，化疗免疫治疗可能是晚期pLELC患者的最佳一线治疗方法。
