Department of Haematology & Oncology, University Department Internal Medicine-Oncology, Pius-Hospital, University Medicine Oldenburg, Oldenburg, Germany.
Department of Medical Oncology, Léon Bérard Cancer Centre, Lyon, France.
Lung Cancer. 2022 Oct;172:65-74. doi: 10.1016/j.lungcan.2022.08.001. Epub 2022 Aug 6.
To describe the impact of immune checkpoint inhibitors (ICIs) on treatment patterns and survival outcomes in patients with locally advanced or metastatic non-small cell lung cancer (aNSCLC) in France and Germany.
Patients with aNSCLC without known ALK or EGFR mutations receiving first-line (1L) therapy were included from (i) the retrospective Epidemiological-Strategy and Medical Economics Advanced and Metastatic Lung Cancer cohort (ESME-AMLC, France; 2015-2018) and (ii) the prospective Clinical Research platform Into molecular testing, treatment and outcome of non-Small cell lung carcinoma Patients platform (CRISP, Germany; 2016-2018). Analyses were stratified according to histology. Survival outcomes were estimated using Kaplan-Meier methodology and stratified by year of 1L therapy. Data sources were analysed separately.
In ESME-AMLC and CRISP, 8,046 and 2,359 patients were included in the study, respectively. In both countries, approximately 20 % of all patients received pembrolizumab monotherapy as 1L treatment in 2018. In ESME-AMLC, the proportion receiving an ICI over the course of treatment (any line) increased from 42.2 % (2015) to 56.1 % (2018) in patients with squamous histology, and 28.9 % to 51.9 % with non-squamous/other; in CRISP, it increased from 50.6 % (2016) to 65.2 % (2018) with squamous histology, and 40.8 % to 62.7 % with non-squamous/other. Two-year overall survival from 1L initiation was 36.8 % and 25.6 % in the squamous cohorts and 36.5 % and 30.8 % in the non-squamous/other cohorts in ESME-AMLC and CRISP, respectively. No significant change in overall survival was observed over time; however, the follow-up time available was limited in the later years of the analysis.
The results of this joint research from two large clinical databases in France and Germany demonstrate the growing use of ICIs in the management of aNSCLC. Future analyses will allow for the evaluation of the impact of ICIs on long-term survival of patients with aNSCLC.
描述免疫检查点抑制剂（ICI）在法国和德国局部晚期或转移性非小细胞肺癌（aNSCLC）患者的治疗模式和生存结果中的影响。
从（i）回顾性流行病学策略和医学经济学高级和转移性肺癌队列（ESME-AMLC，法国；2015-2018 年）和（ii）前瞻性临床研究平台纳入无已知 ALK 或 EGFR 突变的 aNSCLC 患者接受一线（1L）治疗进入分子检测、治疗和非小细胞肺癌患者平台结果（CRISP，德国；2016-2018 年）。分析根据组织学分层。使用 Kaplan-Meier 方法估计生存结果，并按 1L 治疗的年份分层。分别分析数据来源。
在 ESME-AMLC 和 CRISP 中，分别有 8046 名和 2359 名患者纳入研究。在这两个国家，2018 年约有 20%的所有患者接受 pembrolizumab 单药治疗作为 1L 治疗。在 ESME-AMLC 中，接受治疗过程中（任何线）ICI 的比例从鳞状组织学的 42.2%（2015 年）增加到 56.1%（2018 年），非鳞状/其他组织学从 28.9%增加到 51.9%；在 CRISP 中，从鳞状组织学的 50.6%（2016 年）增加到 65.2%（2018 年），非鳞状/其他组织学从 40.8%增加到 62.7%。从 1L 开始的两年总生存率分别为 ESME-AMLC 和 CRISP 鳞状队列的 36.8%和 25.6%，非鳞状/其他队列的 36.5%和 30.8%。随着时间的推移，未观察到总体生存率的显著变化；然而，分析中晚期的随访时间有限。
这项来自法国和德国两个大型临床数据库的联合研究结果表明，ICI 在 aNSCLC 的治疗中得到了越来越多的应用。未来的分析将评估 ICI 对 aNSCLC 患者长期生存的影响。
