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免疫治疗晚期非小细胞肺癌的真实世界生存结局:单中心回顾性研究。

Real-world survival outcomes of immunotherapy for advanced non-small cell lung cancer: A single-center retrospective review.

机构信息

Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

University of Windsor, Windsor, Ontario, Canada.

出版信息

Thorac Cancer. 2024 Feb;15(5):394-401. doi: 10.1111/1759-7714.15205. Epub 2024 Jan 18.

Abstract

BACKGROUND

Non-small cell lung cancer (NSCLC) is often diagnosed at an advanced stage. Clinical trials have demonstrated that first-line immunotherapy alone or in combination with chemotherapy improves overall survival. However, reports of survival outcomes in real-world settings are limited. We assessed survival in advanced NSCLC patients treated with immunotherapy alone or in combination with chemotherapy in first- or second-line at the Windsor Regional Cancer Program (WRCP) and compared it to existing literature.

METHODS

We included patients diagnosed with stage IV NSCLC from January 2015 to December 2020 and treated with first-line chemoimmunotherapy (ChemoImmuno1), chemotherapy followed by immunotherapy (Chemo1), or immunotherapy followed by chemotherapy (Immno1) in our survival analysis. Patients with oncogene-addicted mutations were excluded.

RESULTS

There were 160 patients of which 41.5% were female. Mean age was 68 years. Median overall survival from time of diagnosis was 474 days (95% CI: 249, 949) with an estimated 5-year survival of 11.1% (95% CI: 4.5, 21.3). Median OS in ChemoImmuno1 was 9.6 months, in Chemo1 was 19.2 months from time of diagnosis and 10.5 months from time of initiation of immunotherapy, and in Immuno1 was 18.4 months, respectively. Estimated survival at three years from time of diagnosis for ChemoImmuno1 was 17.6% and for Immuno1 was 17.9%. For Chemo1, from diagnosis it was 20.1% and from second-line therapy it was 15.4%. Survival outcomes were comparable to clinical trials and other studies.

CONCLUSION

Real-world survival outcomes of immunotherapy for advanced NSCLC are comparable to the existing literature in this single center study.

摘要

背景

非小细胞肺癌(NSCLC)通常在晚期诊断。临床试验表明,一线免疫治疗单独或联合化疗可改善总生存期。然而,真实环境下的生存结果报告有限。我们评估了温莎地区癌症项目(WRCP)中接受一线或二线免疫治疗单独或联合化疗治疗的晚期 NSCLC 患者的生存情况,并与现有文献进行了比较。

方法

我们纳入了 2015 年 1 月至 2020 年 12 月期间在 WRCP 诊断为 IV 期 NSCLC 并接受一线化疗免疫治疗(ChemoImmuno1)、化疗后免疫治疗(Chemo1)或免疫治疗后化疗(Immno1)的患者进行生存分析。排除携带致癌基因依赖性突变的患者。

结果

共有 160 名患者,其中 41.5%为女性。平均年龄为 68 岁。从诊断到死亡的中位总生存期为 474 天(95%CI:249,949),估计 5 年生存率为 11.1%(95%CI:4.5,21.3)。ChemoImmuno1 的中位 OS 为 9.6 个月,Chemo1 从诊断到死亡的中位 OS 为 19.2 个月,从免疫治疗开始到死亡的中位 OS 为 10.5 个月,Immuno1 的中位 OS 为 18.4 个月。从诊断开始的三年估计生存率 ChemoImmuno1 为 17.6%,Immuno1 为 17.9%。Chemo1 从诊断开始的生存率为 20.1%,从二线治疗开始的生存率为 15.4%。生存结果与临床试验和其他研究相当。

结论

在这项单中心研究中,真实世界中晚期 NSCLC 免疫治疗的生存结果与现有文献相当。

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