Maugeais Madeleine, Péron Julien, Dalle Stéphane, Boespflug Amélie, Duruissaux Michaël, Corbaux Pauline, Reverdy Thibault, Sahin Gulsum, Rabier Aurélie, Lopez Jonathan, Freymond Nathalie, Maillet Denis
Oncology Department, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), 69495 Pierre-Bénite, France.
Université Claude Bernard Lyon 1, 69100 Villeurbanne, France.
Biomedicines. 2022 Dec 29;11(1):83. doi: 10.3390/biomedicines11010083.
Background: ICIs have dramatically improved patient outcomes in different malignancies. However, the impact of liver metastases (LM) and number of metastatic sites (MS) remains unclear in patients treated with single-agent anti-PD(L)1. Methods: We aimed to assess the prognostic impact of LM and MS number on progression-free survival (PFS) and overall survival (OS) in a large single-arm retrospective multicentric cohort (IMMUCARE) of patients treated with anti-PD(L)-1 for different solid tumors. Results: A total of 759 patients were enrolled from January 2012 to October 2018. The primary tumor types were non-small cell lung cancer (71%), melanoma (19%), or urologic cancer (10%). At the time of ICI initiation, 167 patients (22%) had LM and 370 patients (49%) had more than MS. LM was associated with a shorter median PFS of 1.9 months (95% CI: 1.8−2.5) vs. 4.0 months (95% CI: 3.6−5.4) in patients without LM (p < 0.001). The median OS of patients with LM was of 5.2 months (95% CI: 4.0−7.7) compared with 12.8 months (95% CI: 11.2−15.1) (p < 0.001). Interestingly, LM were not associated with shorter PFS, or OS compared to other MS types (brain, bone, or lung) in patients with only one MS. Patients with multiple MS also had poor clinical outcomes compared to patients with only one MS. The presence of LM and MS number were independent prognostic factors on overall survival. Conclusion: The presence of LM or multiple MS were associated with poorer survival outcomes in patients treated with anti-PD(L)-1.
免疫检查点抑制剂（ICIs）显著改善了不同恶性肿瘤患者的预后。然而，在接受单药抗程序性死亡受体（L）1治疗的患者中，肝转移（LM）和转移部位数量（MS）的影响仍不明确。方法：我们旨在评估在一个大型单臂回顾性多中心队列（IMMUCARE）中，LM和MS数量对接受抗程序性死亡受体（L）-1治疗的不同实体瘤患者无进展生存期（PFS）和总生存期（OS）的预后影响。结果：2012年1月至2018年10月共纳入759例患者。原发肿瘤类型为非小细胞肺癌（71%）、黑色素瘤（19%）或泌尿系统癌症（10%）。在开始使用ICI时，167例患者（22%）有肝转移，370例患者（49%）有多个转移部位。肝转移患者的中位无进展生存期为1.9个月（95%置信区间：1.8−2.5），而无肝转移患者为4.0个月（95%置信区间：3.6−5.4）（p<0.001）。肝转移患者的中位总生存期为5.2个月（95%置信区间：4.0−7.7），而无肝转移患者为12.8个月（95%置信区间：11.2−15.1）（p<0.001）。有趣的是，在只有一个转移部位的患者中，与其他转移部位类型（脑、骨或肺）相比，肝转移与较短的无进展生存期或总生存期无关。与只有一个转移部位的患者相比，有多个转移部位的患者临床结局也较差。肝转移的存在和转移部位数量是总生存期的独立预后因素。结论：在接受抗程序性死亡受体（L）-1治疗的患者中，肝转移或多个转移部位的存在与较差的生存结局相关。
