A Single Center Analysis of Advanced Non-small Cell Lung Cancer Patients Treated with Immunotherapy in Real-world Practice.

Autor:	Yanxia LIU, Tongmei ZHANG, Yuan GAO, Yang QU, Baohua LU, Hongmei ZHANG, Qunhui WANG, Jie LI, Fanbin HU, Baolan LI
Předmět:	RISK factors of pneumonia LUNG cancer prognosis DRUG side effects CONFIDENCE intervals IMMUNOTHERAPY LUNG cancer LUNG tumors MEDICAL practice METASTASIS MULTIVARIATE analysis CARDIOMYOPATHIES RISK assessment STATISTICS SURVIVAL analysis (Biometry) TUMOR classification PLEURAL tumors TREATMENT effectiveness DISEASE incidence RETROSPECTIVE studies ODDS ratio DISEASE risk factors
Zdroj:	Chinese Journal of Lung Cancer; 11/1/2019, Vol. 22 Issue 11, p687-695, 9p, 5 Charts, 2 Graphs
Abstrakt:	Background and objective In recent years, a number of clinical trials have shown that immunocheck-point inhibitors (ICI) have brought survival benefits to patients with advanced non-small cell lung cancer (NSCLC), however, such clinical trials comprise cohorts selected based on strict and complex entry and exclusion criteria, and the results cannot fully reflect the real world situation. The purpose of this study was to investigate the clinical efficacy and safety of immunother¬apy in the real world, as well as possible prognostic factors. Methods Patients with advanced NSCLC receiving immunothera¬py in Beijing Chest Hospital from January 2017 to July 2019 were retrospectively collected, and the following information were collected: curative effect, progression-free surival (PFS) and adverse reactions. The occurrence of adverse reactions and clinical curative effect and prognosis factors that may be relevant were explored. Results 34 patients were enrolled in this study, me¬dian PFS was 5.66 months (95%CI: 4.48-6.84), grade 1-2 and 3-4 incidence of adverse events was 61.71% (22/34) and 14.71% (5/34), there were 3 patients (8.82%) experienced fatal immune related adverse events (irAE), 2 cases were immune associated pneumonia, 1 case was immune related myocarditis. Univariate analysis showed that tumor-node-metastasis (TNM) stage and metastatic site were correlated with median PFS (P<0.05), and multivariate analysis showed that patients with extrapulmonary metastasis (OR=6.42, P=0.029) and pleural metastasis (OR = 14.14, P=0.006) had shorter median PFS. Conclusion In the real world, immunotherapy has good efficacy in patients with advanced NSCLC, but the incidence of severe irAE is also higher. Distant metastasis and pleural metastasis are poor prognostic factors for advanced NSCLC patients receiving immunotherapy. [ABSTRACT FROM AUTHOR]
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