3 research outputs found
Brief Report on the Efficacy of Nivolumab in Patients With Previously Treated Advanced Large-Cell Neuroendocrine Cancer of the Lung
International audienceINTRODUCTION: The optimal management of large cell neuroendocrine cancer of the lung (LCNEC) is unclear, and data regarding anti-programmed cell death protein 1 (PD-1) antibodies are scarce. This study reports the clinical efficacy of a PD-1 inhibitor in patients with advanced LCNEC. METHODS: All patients with stage III to IV LCNEC treated with at least one previous cycle of chemotherapy between January 1, 2015 and December 31, 2018 were reviewed retrospectively. Patients were divided into two groups depending on their exposure to nivolumab as second-line treatment or beyond. The primary objective was to assess nivolumabâs efficacy. RESULTS: A total of 51 patients with advanced LCNEC from eight centers were analyzed, including 17 who received nivolumab. The PD-1 inhibitor was used as second-line treatment in 77% of cases, with a median number of eight doses (range: 1-62). After nivolumab treatment, the median overall survival was 12.1 months (95% confidence interval [CI]: 7.10-14.20). The objective response rate was 29.4% (95% CI: 10.3-56.0), and median progression-free survival was 3.9 months (95% CI: 1.68-7.17). The programmed death-ligand 1 status was unknown. There was no difference in the efficacy of first-line chemotherapy; the objective response rate was 23.5% (n = four of 17) in the nivolumab group versus 32.4% (n = 11 of 34) in the conventional treatment group, and progression-free survival was 3.5 months (95% CI: 1.7-4.4) versus 2.1 months (95% CI: 1.4-4.2), respectively. CONCLUSIONS: In a real-world setting, nivolumab seems to be an effective second-line treatment in patients with advanced LCNEC. Large prospective studies in this setting are still required
Duration of nivolumab for pretreated, advanced nonâsmallâcell lung cancer
Abstract Background A standard of care for pretreated, advanced nonâsmallâcell lung cancers (NSCLCs), nivolumab has demonstrated longâterm benefit when administered for 2 years. We aimed to better discern an optimized administration duration by retrospectively analyzing realâlife longâterm efficacy in a prospective cohort. Methods All nivolumabâtreated adults with advanced NSCLCs (01/09/2015 to 30/09/2016) from nine French centers were eligible. On 31/12/2018, patients who are alive â„ 2 years after starting nivolumab were defined as longâterm survivors (LTSs) and were divided into three nivolumab treatment groups:  2 years. Coâprimary endpoints were LTSsâ progressionâfree survival (PFS) and overall survival (OS). Results The median followâup was 32 months (95% CI, 31.0 to 34.0). The 3âyear OS rate for the 259 cohort patients was 16.6%. Among them, 65 were LTSs: 47 treated  2 years. Their respective characteristics were: median age: 59, 52, and 58 years; smoking history: 92.9, 100, and 100%; adenocarcinomas: 66, 57.1, and 54.5%. LTSsâ median (m)PFS was 28.4 months; mOS was not reached. LTSsâ objective response rate was 61.6%. mOS was 32.7 months for those treated  2âyear group's 3âyear OS was longer. Twentyâeight LTSs experienced no disease progression; 7 had durable complete responses. However, LTSs had more frequent and more severe adverse events. Conclusion In realâlife, prolonged nivolumab use provided longâterm benefit with 16.6% 3âyear OS and 25% LTSs. Survival tended to be prolonged with nivolumab continued beyond 2 years. Prospective randomized trials with adequate design are needed
Firstâline pembrolizumab for nonâsmall cell lung cancer patients with PDâL1Â â„50% in a multicenter realâlife cohort: The PEMBREIZH study
Background: The KEYNOTE-024 trial demonstrated that pembrolizumab, a PD-1 inhibitor, significantly improves progression-free survival (PFS) and overall survival (OS) in selected patients with previously untreated advanced non-small cell lung cancer (NSCLC) with a PD-L1 tumor proportion score (TPS) â„50% and without EGFR/ALK aberrations. The main aim of this study was to report the efficacy and safety profile of pembrolizumab in real-life conditions. Method: This was a French retrospective multicenter longitudinal study of 108 consecutive patients with advanced NSCLC, a PD-L1 TPS â„50% and without EGFR/ ALK aberrations who were treated by pembrolizumab, in first line. Patient data were obtained from medical files. Results: The main characteristics of the cohort were: median age [range] 66.7 [37-87] years, 64.8% male, 23.1% with a performance status (PS) of 2, and 88.9% current or former smokers. Eighty-seven percent had stage IV NSCLC at diagnosis, 9.2% untreated brain metastases at inclusion,. With a median follow-up of 8.2 months, the median PFS was 10.1 months (95% CI, 8.8-11.4). The objective response rate was 57.3% (complete response 2.7%, partial response 54.6%). Disease control rate was 71.1%. At 6 months, the OS rate estimated was 86.2%. Treatment-related adverse events (AE) of grade 3 occurred in 8% of patients. There were no grade 4 or 5 AEs. Conclusion: In a real-life cohort of advanced NSCLC patients (including PS 2 and untreated brain metastases), with PD-L1 TPS â„50%, pembrolizumab demonstrates similar PFS to the pivotal clinical trial