Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia.
Pathol Oncol Res. 2024 Jul 12;30:1611717. doi: 10.3389/pore.2024.1611717. eCollection 2024.
By 2021, the FDA approved the use of the drugs pembrolizumab and atezolizumab in the first-line treatment of patients with high positivity of programmed death ligand-1 (PD-L1) in locally advanced and metastatic non-small-cell-lung cancer (NSCLC). This approval was the result of statistically significant evidence from international, multicentric clinical studies that all reported increasing progression-free survival (PFS) and overall survival (OS) in these patients. In our study, we reported the demographic and clinical characteristics of 79 patients diagnosed with NSCLC with expression of PD-L1 ≥50% from January 2019 to December 2022 at the Institute for Pulmonary Diseases of Vojvodina, who received pembrolizumab therapy as the first-line treatment. Patients were divided according to the histological type of lung cancer as adenocarcinoma (ADC) or squamous cell carcinoma (SCC) of the lung. In 52 of the 79 patients, PFS and in 32 of them overall survival (censored OS) was shown according to the histological type of tumor, the tumor proportion score (TPS) of PDL-1 expression, and the metastatic status within the Tumor Nodes Metastasis (TNM) disease classification. Independent factors of death outcome were shown by multivariable proportional hazard regression analysis. The study included 79 patients diagnosed with NSCLC with an expression of PD-L1 ≥50%, 50 (63.3%) patients with ADC, and 29 (36.7%) patients with SCC, whose 55 (69.6%) PDL-1 expression was obtained from broncho biopsy (BB). The majority of patients, 49 (62%), had a TPS PD-L1 score of 51%-79%. Median, PFS for adenocarcinoma was 22 months and censored OS was 27 months, while for squamous cell carcinoma, median PFS was 12 months, and censored OS was 21 months. M1b disease stage, which was the most common in patients, had a PFS of 16 months and a censored OS of 18 months. Pembrolizumab monotherapy in patients with NSCLC in the fourth stage of the disease and with the positivity of the immune checkpoint protein TPS PD-L1 above 50% represents a safe therapy that allows a satisfactory period without disease progression and overall survival with acceptable treatment complications.
截至 2021 年，美国食品药品监督管理局（FDA）批准了药物 pembrolizumab 和 atezolizumab 用于治疗局部晚期和转移性非小细胞肺癌（NSCLC）中程序性死亡配体 1（PD-L1）高阳性患者的一线治疗。这一批准是基于国际多中心临床研究的统计学显著证据，这些研究均报告了这些患者无进展生存期（PFS）和总生存期（OS）的延长。在我们的研究中，我们报告了 2019 年 1 月至 2022 年 12 月期间在伏伊伏丁那肺病研究所诊断为 PD-L1 表达≥50%的 79 例 NSCLC 患者的人口统计学和临床特征，这些患者接受 pembrolizumab 作为一线治疗。患者根据肺癌的组织学类型分为腺癌（ADC）或肺鳞状细胞癌（SCC）。在 79 例患者中的 52 例中，根据肿瘤的组织学类型、肿瘤比例评分（TPS）的 PD-L1 表达和肿瘤淋巴结转移（TNM）疾病分类内的转移状态显示了 PFS，在 32 例中显示了总生存（截尾 OS）。通过多变量比例风险回归分析显示了死亡结局的独立因素。本研究纳入了 79 例 PD-L1 表达≥50%的 NSCLC 患者，其中 50 例（63.3%）为 ADC，29 例（36.7%）为 SCC，其中 55 例（69.6%）的 PD-L1 表达来自支气管活检（BB）。大多数患者（62%）的 TPS PD-L1 评分在 51%-79%之间。中位 ADC 的 PFS 为 22 个月，截尾 OS 为 27 个月，而 SCC 的中位 PFS 为 12 个月，截尾 OS 为 21 个月。M1b 疾病分期是患者中最常见的，PFS 为 16 个月，截尾 OS 为 18 个月。对于 PD-L1 免疫检查点蛋白 TPS 阳性率>50%的第四期 NSCLC 患者，pembrolizumab 单药治疗是一种安全的治疗方法，可使患者无疾病进展期和总生存期令人满意，治疗相关并发症可接受。
