Nguyen Khanh Toan, Van To Ta
Department of Oncology, Hanoi Medical University, Hanoi City, Hanoi, Vietnam.
Department of Medical Oncology 2, Nghe An Oncology Hospital, Nghe An Province, Nghe An, Vietnam.
J Immunother Precis Oncol. 2023 Aug 7;6(3):133-140. doi: 10.36401/JIPO-23-12. eCollection 2023 Aug.
Lung cancer has been one of the most prevalent cancers worldwide in recent decades. According to the findings of the KEYNOTE-407 (2018) study on patients with stage IV squamous cell lung cancer, the combination of pembrolizumab and chemotherapy in the first-line treatment prolongs overall survival compared with chemotherapy alone. This study aimed to evaluate the efficacy and side effects of treating patients with stage IV non-small cell lung cancer with pembrolizumab in combination with platinum-based doublet chemotherapy.
A retrospective multicenter study on 46 patients at four hospitals in Vietnam between June 2018 and August 2022. Patients received first-line treatment with a protocol of pembrolizumab in combination with platinum-based doublet chemotherapy (pemetrexed plus carboplatin or paclitaxel plus carboplatin). The study's primary endpoints were progression-free survival and safety. The secondary endpoint was overall survival.
The median progression-free survival was 11.0 months (95% CI, 7.4-14.7 months). The median overall survival was 23.1 months (95% CI, 18.4-27.8 months). The survival rate of patients after 1 and 2 years was 82.3% and 43.3%, respectively. The most common side effects were anemia and elevated liver enzymes, but they were primarily mild or moderate severity. Progression-free survival did not depend on cancer type based on histology ( = 0.13). The progression-free survival was independent of programmed death ligand-1 expression levels < 50% or ≥ 50% ( = 0.68).
Treatment of stage IV non-small cell lung cancer without and gene mutations with the immunotherapy protocol of pembrolizumab in combination with platinum-based doublet chemotherapy resulted in favorable outcomes without any new safety concerns. A larger sample size and longer follow-up in the future are necessary to yield more complete results.
近几十年来，肺癌一直是全球最常见的癌症之一。根据KEYNOTE - 407（2018年）针对IV期鳞状细胞肺癌患者的研究结果，一线治疗中帕博利珠单抗与化疗联合使用比单纯化疗能延长总生存期。本研究旨在评估帕博利珠单抗联合铂类双药化疗治疗IV期非小细胞肺癌患者的疗效和副作用。
对2018年6月至2022年8月期间越南四家医院的46例患者进行回顾性多中心研究。患者接受一线治疗，方案为帕博利珠单抗联合铂类双药化疗（培美曲塞加卡铂或紫杉醇加卡铂）。该研究的主要终点是无进展生存期和安全性。次要终点是总生存期。
中位无进展生存期为11.0个月（95%可信区间，7.4 - 14.7个月）。中位总生存期为23.1个月（95%可信区间，18.4 - 27.8个月）。1年和2年后患者的生存率分别为82.3%和43.3%。最常见的副作用是贫血和肝酶升高，但主要为轻度或中度严重程度。无进展生存期不取决于基于组织学的癌症类型（P = 0.13）。无进展生存期与程序性死亡配体-1表达水平<50%或≥50%无关（P = 0.68）。
对于无 和 基因突变的IV期非小细胞肺癌患者，采用帕博利珠单抗联合铂类双药化疗的免疫治疗方案可产生良好效果，且无任何新的安全问题。未来需要更大的样本量和更长时间的随访以获得更完整的结果。
