Evaluation of Response to Immune Checkpoint Inhibitor Monotherapy or
Combination with Chemotherapy for Patients with Advanced Non-small Cell Lung Cancer and High PD-L1 Expression.
10.3779/j.issn.1009-3419.2021.103.02
- Author:
Haoyang LI
1
;
Na QIN
1
;
Mengjun YU
1
;
Li MA
1
;
Yuhua WU
1
;
Hui ZHANG
1
;
Xinyong ZHANG
1
;
Xi LI
1
;
Jinghui WANG
1
Author Information
1. Department of Medical Oncology, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
- Publication Type:Journal Article
- Keywords:
Combination chemotherapy;
Immune checkpoint blockade;
Lung neoplasms;
Monotherapy;
Programmed cell death-ligand 1
- From:
Chinese Journal of Lung Cancer
2021;24(3):161-166
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Immunotherapy represented by immune checkpoint inhibitors (ICIs) has been widely used in the treatment of lung cancer. There are controversies in clinical practice for patients with advanced non-small cell lung cancer (NSCLC) and high programmed cell death-ligand 1 (PD-L1) expression receiving ICIs monotherapy or combination chemotherapy.
METHODS:This study retrospectively analyzed the clinical data of 49 patients with advanced NSCLC and high PD-L1 expression. Immunohistochemistry was performed with 22C3 antibody, and the expression level of PD-L1 was evaluated according to tumor proportion score (TPS). Objective response rate (ORR) and progression free survival (PFS) were compared by groups of different clinical characteristics.
RESULTS:ORR of monotherapy and combination therapy group was 47.1% (8/17) and 43.8% (14/32), respectively, without statistical difference (P=0.825). The median PFS of monotherapy and combination therapy group was 8.0 months and 6.8 months, respectively, without statistical difference (P=0.502). Statistical analysis of predictors of immunotherapy for the patients showed first-line immunotherapy had better ORR than subsequent immunotherapy (12/19, 63.2% vs 10/30, 33.3%, P=0.041), however no difference in PFS. And there were no differences in ORR or PFS among groups of age, gender, smoking status, performance status (PS), pathological type, tumor size and tumor-node-metastasis (TNM) stage.
CONCLUSIONS:The therapeutic effect is similar between ICIs monotherapy and combination chemotherapy for patients with advanced NSCLC and high PD-L1 expression. ORR of first-line immunotherapy was better in patients with advanced NSCLC and high PD-L1 expression. The optimal treatment for this population remains further prospective clinical studies.
