Predictive and prognostic clinical and pathological factors of nivolumab efficacy in non-small-cell lung cancer patients
Por:
Garde-Noguera J, Martin-Martorell P, De Julian M, Perez-Altozano J, Salvador-Coloma C, Garcia-Sanchez J, Insa-Molla A, Martin M, Mielgo-Rubio X, Marin-Liebana S, Blasco-Cordellat A, Blasco-Molla S, Girones R, Marquez-Medina D, Aparisi F, Cerda MCB, Macia-Escalante S, Sanchez A and Juan-Vidal O
Publicada:
1 ago 2018
Ahead of Print:
24 ene 2018
Resumen:
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.
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.
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).
Poor PS, short period of time since the previous treatment, and more than one metastatic location were associated with poorer prognostic.
Filiaciones:
:
Hospital Arnau de Vilanova, C/Sant Climent, 12, 46015, Valencia, Spain.
Martin-Martorell P:
University Hospital Clínic de Valencia, Valencia, Spain
De Julian M:
Hospital Provincial de Castellon, Castellon, Spain
:
Hospital General de Elche, Elche, Spain
Salvador-Coloma C:
Hospital Universitari I Politècnic La Fe, Valencia, Spain
:
Hospital Arnau de Vilanova, C/Sant Climent, 12, 46015, Valencia, Spain
Insa-Molla A:
University Hospital Clínic de Valencia, Valencia, Spain
Martin M:
Hospital Dr Peset, Valencia, Spain
Mielgo-Rubio X:
Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
Marin-Liebana S:
Hospital de Manises, Manises, Spain
Blasco-Cordellat A:
Hospital General Universitario de Valencia, Valencia, Spain
:
Hospital de Sagunto, Sagunto, Spain
:
Hospital Lluis Alcanyís, Xátiva, Spain
Marquez-Medina D:
Hospital Arnau de Vilanova, Lleida, Spain
:
Hospital Virgen de los Lirios, Alcoy, Spain
Cerda MCB:
Universidad Politecnica de Valencia, Valencia, Spain
Macia-Escalante S:
Pivotal CRO, Madrid, Spain
:
Hospital Provincial de Castellon, Castellon, Spain
Juan-Vidal O:
Hospital Universitari I Politècnic La Fe, Valencia, Spain
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