Survival benefit with checkpoint inhibitors versus chemotherapy is modified by brain metastases in patients with recurrent small cell lung cancer.
| Autor: | Althoff FC; Department of Internal Medicine II, Hematology, Oncology, University Hospital Frankfurt, Frankfurt, Germany., Schäfer LV; Department of Internal Medicine II, Hematology, Oncology, University Hospital Frankfurt, Frankfurt, Germany., Acker F; Department of Internal Medicine II, Hematology, Oncology, University Hospital Frankfurt, Frankfurt, Germany., Aguinarte L; Department of Internal Medicine II, Hematology, Oncology, University Hospital Frankfurt, Frankfurt, Germany., Heinzen S; Department of Internal Medicine II, Hematology, Oncology, University Hospital Frankfurt, Frankfurt, Germany., Rost M; Department of Internal Medicine II, Hematology, Oncology, University Hospital Frankfurt, Frankfurt, Germany., Atmaca A; Department of Oncology and Hematology, Krankenhaus Nordwest, University Cancer Center Frankfurt (UCT)-University Cancer Center, Frankfurt, Germany., Rosery V; Department of Medical Oncology, West German Cancer Center, University Medicine Essen, Essen, Germany., Alt J; Department of Internal Medicine III, Hematology, Oncology, University Medical Center Mainz, Mainz, Germany., Waller CF; Department of Internal Medicine I, Haematology, Oncology and Stem Cell Transplantation, Freiburg University Medical Center and Faculty of Medicine, Freiburg, Germany., Reinmuth N; Department of Oncology, Asklepios Clinic München-Gauting, Gauting, Germany., Rohde G; Department of Respiratory Medicine, Medical Clinik 1, University Hospital Frankfurt, Frankfurt, Germany., Saalfeld FC; Department for Internal Medicine I, University Hospital Carl Gustav Carus Dresden, Technical University of Munich (TU) Dresden, Dresden, Germany., Becker von Rose A; Department of Internal Medicine III, Klinikum rechts der Isar, Technical University Munich, Munich, Germany., Möller M; Department of Internal Medicine II, Martha - Maria Hospital Halle, Halle, Germany., Frost N; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Infectious Diseases and Pulmonary Medicine, Berlin, Germany., Sebastian M; Department of Internal Medicine II, Hematology, Oncology, University Hospital Frankfurt, Frankfurt, Germany., Stratmann JA; Department of Internal Medicine II, Hematology, Oncology, University Hospital Frankfurt, Frankfurt, Germany. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in oncology [Front Oncol] 2023 Sep 22; Vol. 13, pp. 1273478. Date of Electronic Publication: 2023 Sep 22 (Print Publication: 2023). |
| DOI: | 10.3389/fonc.2023.1273478 |
| Abstrakt: | Introduction: Small cell lung cancer (SCLC) is a rapidly growing malignancy with early distant metastases. Up to 70% will develop brain metastases, and the poor prognosis of these patients has not changed considerably. The potential of checkpoint inhibitors (CPI) in treating recurrent (r/r) SCLC and their effect on brain metastases remain unclear. Methods: In this retrospective multicenter study, we analyzed r/r SCLC patients receiving second or further-line CPI versus chemotherapy between 2010 and 2020. We applied multivariable-adjusted Cox regression analysis to test for differences in 1-year mortality and real-world progression. We then used interaction analysis to evaluate whether brain metastases (BM) and/or cranial radiotherapy (CRT) modified the effect of CPI versus chemotherapy on overall survival. Results: Among 285 patients, 99 (35%) received CPI and 186 (65%) patients received chemotherapy. Most patients (93%) in the CPI group received nivolumab/ipilimumab. Chemotherapy patients were entirely CPI-naïve and only one CPI patient had received atezolizumab for first-line treatment. CPI was associated with a lower risk of 1-year mortality (adjusted Hazard Ratio [HR Conclusion: CPI was associated with a lower risk of 1-year mortality compared to chemotherapy. However, the effect on OS was significantly modified by intracranial disease and radiotherapy, suggesting the benefit was driven by patients without BM. Competing Interests: Outside of the submitted work, the following authors report personal fees, research funding, and travel grants as detailed below: AA reports personal fees from BMS, MSD, Roche, Takeda, Pfizer, Novartis, Astra Zeneca, Sanofi, Amgen, Biontech, reports travel grants from BMS, Roche. CW reports personal fees by Amgen, Astra Zeneca, Boehringer Ingelheim, BMS, Chugai, Lilly, Merck, MSD, Novartis, Pfizer, Roche and Takeda. Consultancy fees by Viatris, Avotech and Roche. Travel grants by Amgen, BMS, Janssen and Lilly. FS reports personal fees from Janssen, personal fees from Takeda, personal fees from Pfizer, personal fees from Novartis, personal fees from AstraZeneca, personal fees from Lilly, personal fees from Thieme, research funding from Roche. GR reports personal fees from Astra Zeneca, Atriva, Boehringer Ingelheim, GSK, Insmed, MSD, Sanofi, Novartis, Pfizer, Berlin Chemie, BMS, Chiesi, Essex Pharma, Grifols, Roche, Solvay, Takeda, and Vertex. JA reports personal fees from AstraZeneca, BMS, Roche, Boehringer-Ingelheim, participates in advisory councils or committees for AstraZeneca, MSD, Novartis, Roche, BMS, Janssen, Merck. JAS reports personal fees from Boehringer Ingelheim, personal fees from AstraZeneca, personal fees from Roche, personal fees from BMS, personal fees from Amgen, personal fees from LEO pharma, personal fees from Novartis, personal fees from Takeda, outside of the submitted work. MS reports personal fees from Lilly, personal fees from Astra-Zeneca, personal fees from Bristol-Myers & Squibb, personal fees from Merck Sharp & Dohme, personal fees from Pfizer, personal fees from Takeda, personal fees from Roche, personal fees from AbbVie, personal fees from Boehringer-Ingelheim, personal fees from Celgene, personal fees from Novartis, outside the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Althoff, Schäfer, Acker, Aguinarte, Heinzen, Rost, Atmaca, Rosery, Alt, Waller, Reinmuth, Rohde, Saalfeld, Becker von Rose, Möller, Frost, Sebastian and Stratmann.) |
| Databáze: | MEDLINE |
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