Challenges and knowledge gaps with immune checkpoint inhibitors monotherapy in the management of patients with non-small-cell lung cancer: a survey of oncologist perceptions.

Autor:	Castelo-Branco L; NOVA National School of Public Health, NOVA University, Lisbon, Portugal. Electronic address: luismocb@hotmail.com., Morgan G; Skåne University Hospital, Division of Medical and Radiation Oncology, Lund, Sweden., Prelaj A; Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy., Scheffler M; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Cologne, Germany., Canhão H; EPIDOC Unit, Comprehensive Health Research Center (CHRC), NOVA Medical School, NOVA University, Lisbon; Centro Hospitalar Universitario Lisboa Central, Lisbon, Portugal., Van Meerbeeck JP; Thoracic Oncology, Antwerp University & University Hospital, Edegem., Awada A; Oncology Medicine Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Jazyk:	angličtina
Zdroj:	ESMO open [ESMO Open] 2023 Feb; Vol. 8 (1), pp. 100764. Date of Electronic Publication: 2023 Jan 12.
DOI:	10.1016/j.esmoop.2022.100764
Abstrakt:	Background: Immune checkpoint-inhibitors (ICIs) are changing outcomes in different cancer settings, notably for patients with non-small-cell lung cancer (NSCLC). There are, however, still important gaps of evidence for clinical practice when using these novel treatments. In this study, we assessed physicians' opinion and experience on challenges for clinical practice with ICIs monotherapy in NSCLC. Methods: A survey was conducted on experienced physicians treating patients with NSCLC with ICIs. Two rounds of pilot tests were carried out for validation among a group of experts. Topics under analysis were in relation to treatment of elderly populations, performance status, brain metastases, use of steroids or antibiotics, the effects of gut microbiome, autoimmune diseases, human immunodeficiency virus infection, solid organ transplants, use of anti-programmed cell death protein 1 versus anti-programmed death-ligand 1 drugs, atypical tumour responses, predictors of response, duration of treatment and a final open question on additional relevant challenges. Results: Two hundred and twenty-one answers were collected, including 106 (48%) valid answers from experts for final analysis (physicians who have treated at least 20 patients with NSCLC with ICIs). The vast majority agreed that the selected topics in this study are important challenges ahead and more evidence is needed. Moreover, predictors of response, treating brain metastasis, shorter duration of treatment, the effects of gut microbiome and concomitant use of steroids were voted the most important topics to be further addressed in prospective clinical research. Conclusions: This survey contributed to understanding which are the main challenges for clinical practice with ICIs monotherapy in NSCLC. It can also contribute to guide further clinical research, considering the opinions and experience of those who regularly treat NSCLC patients with ICIs. Competing Interests: Disclosure GM reports support for advisory board/consultation positions for AstraZeneca, Roche, Novartis, Lilly and Pfizer. AP reports honoraria and/or advisory fees from: AstraZeneca, Bristol Myers Squibb (BMS), Roche/Italfarma. MS reports honoraria and/or advisory fees from: Amgen, AstraZeneca, BMS, Boehringer Ingelheim, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi Avemtis, Siemens Healthineers, Takeda. He also declares research support (institutional) from: Amgen, BMS, Dracen Pharmaceuticals, Janssen, Novartis, Pfizer, Siemens Healthineers. AA took part in advisory boards for Amgen, AstraZeneca, Bayer, Daiichi, EISAI, Genomic Health, Hengrui, Innate, Ipsen, Leo Pharma, Lilly, Merck, Merck Sharp & Dohme (MSD), Novartis, Pfizer, Seattle Genetics. He received speaker fees from Amgen, AstraZeneca, Bayer, Daiichi, Eisai, Genomic Health, Ipsen, Leo Pharma, Lilly, Merck, MSD, Novartis, Pfizer, Seattle Genetics. He received research grants from BMS, Roche. All other authors have declared no conflicts of interests. (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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