Association Between Clinical Tumor Burden and Efficacy of Immune Checkpoint Inhibitor Monotherapy for Advanced Non-Small-Cell Lung Cancer.

Abstract:

BACKGROUND:Programmed cell death 1 (PD-1) inhibitors have become a standard treatment, albeit not completely effective, for patients with advanced non-small-cell lung cancer (NSCLC). Previous studies of advanced melanoma have revealed that the tumor burden predicted the response to PD-1 inhibitors, although this relationship has remained unclear for NSCLC. PATIENTS AND METHODS:The present single-center retrospective study evaluated 163 patients with advanced NSCLC who had received PD-1/programmed cell death ligand 1 (PD-L1) inhibitor monotherapy from December 2015 to December 2018. The clinical tumor burden was estimated using the baseline sum of the target lesions' longest diameters (BSLDs), measured according to the Response Evaluation Criteria for Solid Tumors, and the baseline number of metastatic lesions (BNMLs). RESULTS:The optimal cutoff values for predicting progression-free survival (PFS) were 5 for the BNMLs and 76 mm for the BSLDs, using the minimum P value method. The low-BNML group included 73 patients (44.8%). The median PFS was 12.2 months in the low-BNML group and 2.8 months in the high-BNML group (hazard ratio, 0.51; P = .0005). The low-BSLD group included 92 patients (56.4%). The median PFS was 9.6 months in the low-BSLD group and 3.4 months in the high-BSLD group (hazard ratio, 0.52; P = .0006). Multivariable analysis revealed that low-BSLD, low-BNML, nonsquamous histologic type and a PD-L1 tumor proportion score of ≥ 50% were independently associated with prolonged PFS. CONCLUSIONS:PD-L1 expression and the clinical tumor burden can predict the efficacy of PD-1/PD-L1 inhibitor monotherapy for NSCLC.

journal_name

Clin Lung Cancer

journal_title

Clinical lung cancer

authors

Miyawaki T,Kenmotsu H,Mori K,Miyawaki E,Mamesaya N,Kawamura T,Kobayashi H,Omori S,Wakuda K,Ono A,Naito T,Murakami H,Harada H,Endo M,Ohde Y,Takahashi K,Takahashi T

doi

10.1016/j.cllc.2020.02.012

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

e405-e414

issue

5

eissn

1525-7304

issn

1938-0690

pii

S1525-7304(20)30037-1

journal_volume

21

pub_type

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