Does nivolumab for progressed metastatic lung cancer fulfill its promises? An efficacy and safety analysis in 20 general hospitals
| Autor: | Luc Van Zandweghe, Daniella Galdermans, K Pat, Isabelle Fabry, Ingel K. Demedts, Isabelle Declercq, Rika Van Herreweghe, Michiel Thomeer, Kurt G. Tournoy, Patrick Alexander, Sofie De Craene, Valerie Van Damme, Heidi Marien, Luc Vanmaele, Nele De Brucker, Paul Germonpré, Piet Vercauter, Rob Schildermans, Sofie Derijcke, Rebecca De Pauw, Elke Govaerts, Karl Govaert |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Pulmonary and Respiratory Medicine Oncology Cancer Research medicine.medical_specialty Lung Neoplasms Programmed Cell Death 1 Receptor Population Antineoplastic Agents Hospitals General Metastasis 03 medical and health sciences 0302 clinical medicine Case mix index Belgium Carcinoma Non-Small-Cell Lung Internal medicine medicine Humans Neoplasm Metastasis Lung cancer education Adverse effect Aged Neoplasm Staging Retrospective Studies Aged 80 and over education.field_of_study business.industry Pneumonia Middle Aged Colitis medicine.disease Survival Analysis Confidence interval Surgery Nivolumab 030104 developmental biology Docetaxel 030220 oncology & carcinogenesis Female Immunotherapy Neoplasm Recurrence Local business medicine.drug |
| Zdroj: | Lung Cancer. 115:49-55 |
| ISSN: | 0169-5002 |
| DOI: | 10.1016/j.lungcan.2017.11.008 |
| Popis: | In patients with refractory or recurrent non-small-cell lung cancer (NSCLC) after first line chemotherapy, phase III trials showed superiority of nivolumab, an IgG4 programmed death-1 immune-checkpoint-inhibitor antibody, over docetaxel. We evaluated case mix, effectiveness and safety of nivolumab upon implementation in general practice.In 20 general hospitals, all consecutive NSCLC patients treated with nivolumab within the medical need program (inclusion period 12 months) in Flanders - Belgium were evaluated.There were 267 patients, Eastern Cooperative Oncology Group (ECOG) score was 2 in 24% and 0-1 in 76%. In 48%, two or more systemic regimens were given before nivolumab. The median overall survival was 7.8 months (95% confidence interval (CI) 6.3-9.3). At one year, the overall survival rate was 36.5±0.34%. Median progression-free survival was 3.7 months (95% CI 2.9-4.5). An objective response was obtained in 23.2%. ECOG score 2 and presence of liver metastasis strongly correlated with worse survival (p0.00001). Treatment related adverse events grade 3 or 4 were reported in 21%, colitis (4%) and pneumonitis (7%) were most frequent.Upon implementation of nivolumab therapy in general hospitals, the case mix was characterized by a more heavily pretreated population with a substantial fraction of patients with ECOG score 2. The median overall survival is slightly inferior to what was published in the randomized phase III trials. An ECOG score 2 and the presence of liver metastasis correlated strongly with a worse survival. We report a high prevalence of serious adverse events. |
| Databáze: | OpenAIRE |
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