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Predictive and prognostic clinical and pathological factors of nivolumab efficacy in non-small-cell lung cancer patients

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A Correction to this article was published on 09 July 2018

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Abstract

Background

Immunotherapy increases overall response rate (ORR) and overall survival (OS) in patients with non-small-cell lung cancer (NSCLC). Prognostic and predictive factors are a high need.

Patients and methods

Retrospective review of NSCLC patients treated with nivolumab was performed. Analyzed variables included age, sex, stage, performance status (PS), location of metastases, presence of tumour-related symptoms and comorbidities, number of metastasis locations, previous chemotherapy, anti-angiogenic and radiotherapy treatments, and analytical data from the standard blood count and biochemistry.

Results

A total of 175 patients were included. Median age was 61.5 years, 73.1% were men, 77.7% were ECOG-PS 0–1, and 86.7% were included with stage IV disease. Histology was non-squamous in 77.1%. Sixty-five received nivolumab in second line (37.1%). Thirty-eight patients had brain metastasis (22%), and 39 (22.3%) liver metastasis and 126 (72%) had more than one metastatic location. The ORR was 15.7% with median Progression free survival (PFS) 2.8 months and median OS 5.81 months. Stage III vs IV and time since the beginning of the previous line of treatment ≥ 6 vs < 6 months were associated with better response. PS 2, time since the previous line of treatment < 6 vs ≥ 6 months, and more than one metastatic location were independently associated with shorter OS in multivariable analysis (7.8 vs 2.7 months, 11.2 vs 4.6 months, and 9.4 vs 5.1 month). Finally, time since the previous treatment < 6 vs ≥ 6 months and more than one metastatic location were independently associated with shorter PFS in multivariable analysis (4.3 vs 2.3 months and 4.7 vs 2.3 months).

Conclusion

Poor PS, short period of time since the previous treatment, and more than one metastatic location were associated with poorer prognostic.

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Change history

  • 09 July 2018

    Clinical and Translational Oncology.

References

  1. International Agency for Research on Cancer (IARC). Latest world. Cancer Statistics. IARC, Lyon, France; 2013.

  2. Berrino F. The EUROCARE study: strengths, limitations and perspectives of population-based, comparative survival studies. Ann Oncol. 2003;14(Suppl 5):v9–13.

    Article  PubMed  Google Scholar 

  3. Morgensztern D, Ng SH, Gao F, Govindan R. Trends in stage distribution for patients with non-small cell lung cancer: a National Cancer Database survey. J Thorac Oncol. 2010;5(1):29–33.

    Article  PubMed  Google Scholar 

  4. Cufer T, Ovcaricek T, O’Brien ME. Systemic therapy of advanced non-small cell lung cancer: major-developments of the last 5-years. Eur J Cancer. 2013;49(6):1216–25.

    Article  PubMed  CAS  Google Scholar 

  5. Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, et al. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med. 2006;355(24):2542–50.

    Article  PubMed  CAS  Google Scholar 

  6. Kader Y, Le Chevalier T, El-Nahas T, Sakr A. Comparative study analyzing survival and safety of bevacizumab/carboplatin/paclitaxel and cisplatin/pemetrexed in chemotherapy-naïve patients with advanced non-squamous bronchogenic carcinoma not harboring EGFR mutation. Oncol Targets Ther. 2013;6:803–9.

    Google Scholar 

  7. Weiss JM, Stinchcombe TE. Second-line therapy for advanced NSCLC. Oncologist. 2013;18(8):947–53.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Sanofi-Aventis U.S. TAXOTERE, prescribing information, (docetaxel) Injection concentrate, intravenous infusión (IV), NJ, USA. 2013; 6 Eli Lilly and Company Limited. Alimta (pemetrexed) summary of product characteristics; 2012.

  9. Scagliotti GV, Parikh P, von Pawel J, Biesma B, Vansteenkiste J, Manegold C, et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol. 2008;26:3543–51.

    Article  PubMed  CAS  Google Scholar 

  10. Roche Products Limited. Tarceva (erlotinib) summary of product characteristics; 2014.

  11. Garon EB, Ciuleanu TE, Arrieta O, Prabhash K, Syrigos KN, Goksel T, et al. Ramucirumab plus docetaxel versus placebo plus docetaxel for second-line treatment of stage IV non-small-cell lung cancer after disease progression on platinum-based therapy (REVEL): a multicenter, double-blind, randomised phase 3 trial. Lancet. 2014;384:665–73.

    Article  PubMed  CAS  Google Scholar 

  12. Reck M, Kaiser R, Mellemgaard A, Douillard JY, Orlov S, Krzakowsky M, et al. Docetaxel plus nintedanib versus docetaxel plus placebo in patients with previously treated non-small-cell lung cancer (LUME-LUNG 1): a phase 3, double-blind, randomised controlled trial. Lancet Oncol. 2014;15:143–55.

    Article  PubMed  CAS  Google Scholar 

  13. Borghaei H, Paz-Ares L, Horn L, Spigel D, Steins M, Ready NE, et al. Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. N Eng J Med. 2015;373:1627–39.

    Article  CAS  Google Scholar 

  14. Brahmer J, Reckamp KL, Baas P, Crinò L, Eberhardt WE, Poddubskaya E, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Eng J Med. 2015;373:123–35.

    Article  CAS  Google Scholar 

  15. Commmitee for Medicinal Products for Human Use (CHMP). European Medicines Agency Assessment report of Opdivo. EMA/246304/2016; 2016.

  16. Garon EB, Rizvi NQ, Hui R, Leigh N, Balmanoukian AS, Eder JP, et al. Pembrolizumab for the treatment of non-small-cell lung cancer. N Eng J Med. 2015;372:2018–28.

    Article  Google Scholar 

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Correspondence to J. Garde-Noguera.

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The authors have no relevant affiliations with any organization or entity with a financial interest in with the subject matter or materials discussed in the manuscript.

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This study was approved by the Local Research Ethics Committees and was executed in accordance with the Declaration of Helsinki, Good Clinical Practice, and local ethical and legal requirements.

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All enrolled patients signed informed consent.

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Garde-Noguera, J., Martin-Martorell, P., De Julián, M. et al. Predictive and prognostic clinical and pathological factors of nivolumab efficacy in non-small-cell lung cancer patients. Clin Transl Oncol 20, 1072–1079 (2018). https://doi.org/10.1007/s12094-017-1829-5

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