The efficacy of immunotherapy and chemoimmunotherapy in patients with advanced rare tumors: A Turkish oncology group (TOG) study.

Autor: Guven DC; Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey., Aykan MB; Department of Medical Oncology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey., Muglu H; Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey., Bayram E; Department of Medical Oncology, Cukurova University, Adana, Turkey., Helvaci K; Memorial Ankara Hospital, Ankara, Turkey., Dursun B; Department of Medical Oncology, Ankara University, Ankara, Turkey., Celayir M; Department of Medical Oncology, MAA Acıbadem University, İstanbul, Turkey., Chelebiyev E; Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey., Nayir E; Department of Medical Oncology, Mersin Medical Park Hospital, Mersin, Turkey., Erman M; Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey., Sezer A; Baskent University Adana Hospital, Adana, Turkey., Urun Y; Department of Medical Oncology, Ankara University, Ankara, Turkey., Demirci U; Memorial Ankara Hospital, Ankara, Turkey., Er O; Department of Medical Oncology, MAA Acıbadem University, İstanbul, Turkey., Disel U; Department of Medical Oncology, Acibadem Adana Hospital, Adana, Turkey., Bilici A; Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey., Arslan C; Department of Medical Oncology, School of Medicine, Medical Park Hospital, Izmir Economy University, Izmir, Turkey., Karadurmus N; Department of Medical Oncology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey., Kilickap S; Department of Medical Oncology, Istinye University Faculty of Medicine, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2024 Jan; Vol. 13 (1), pp. e6869. Date of Electronic Publication: 2023 Dec 22.
DOI: 10.1002/cam4.6869
Abstrakt: Introduction: The advances in immune checkpoint inhibitors (ICIs) were relatively slow in rare tumors. Therefore, we conducted a multi-center study evaluating the efficacy of ICI monotherapy and the combination of ICIs with chemotherapy (CT) in patients with advanced rare tumors.
Methods: In this retrospective cohort study, we included 93 patients treated with ICIs for NCI-defined rare tumors from the 12 cancer centers in Turkey. The primary endpoints were the overall response (ORR) and disease control rate (DCR).
Results: The cohort's median age was 56, and 53.8% of the patients were male. The most frequent diagnosis was sarcoma (29%), and 81.7% of the patients were previously treated with at least one line of systemic therapy in the advanced stage. The ORR and DCR were 36.8% and 63.2%, respectively. The germ cell tumors had the lowest ORR (0%), while the Merkel cell carcinoma had the highest ORR to ICIs (57.1%). Patients treated with ICI + ICI or ICI plus chemotherapy combinations had higher ORR (55.2% vs. 27.6%, p = 0.012) and DCR (82.8% vs. 53.4%, p = 0.008). The median OS was 13.47 (95% CI: 7.79-19.15) months, and the six and 12-month survival rates were 71% and 52%. The median duration of response was 16.59 months, and the 12-month progression-free survival rate was 66% in responders. The median time-to-treatment failure was 5.06 months (95% CI: 3.42-6.71). Three patients had high-grade irAEs with ICIs (grade 3 colitis, grade 3 gastritis, and grade 3 encephalitis in one patient each).
Conclusion: We observed over 30% ORR and a 13-month median OS in patients with rare cancers treated with ICI monotherapy or ICI plus CT combinations. The response rates to ICIs or ICIs plus CT significantly varied across different tumor types. Responding patients had over 2 years of survival, highlighting a need for further trials with ICIs for patients with rare tumors.
(© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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