Duration of nivolumab for pretreated, advanced non–small‐cell lung cancer

Autor: Gilles Robinet, Margaux Geier, Christos Chouaid, François Lucia, R. Lamy, Guillaume Léveiller, Romain Corre, Jean-Louis Bizec, Emilie Burte, Elisabeth Gaye, Karim Amrane, Cyril Bernier, Renaud Descourt, Éric Goarant, Gilles Quere
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Adult
Male
Cancer Research
medicine.medical_specialty
Lung Neoplasms
Time Factors
non–small‐cell lung cancer
real‐life
lcsh:RC254-282
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Cancer Survivors
law
Internal medicine
Carcinoma
Non-Small-Cell Lung
medicine
Humans
Radiology
Nuclear Medicine and imaging
Adverse effect
Prospective cohort study
Lung cancer
Objective response
Immune Checkpoint Inhibitors
Aged
Retrospective Studies
Original Research
Aged
80 and over
nivolumab
treatment duration
business.industry
long‐term survivors
Clinical Cancer Research
Middle Aged
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Progression-Free Survival
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Cohort
Female
Non small cell
France
immunotherapy
Nivolumab
business
Zdroj: Cancer Medicine, Vol 9, Iss 19, Pp 6923-6932 (2020)
Cancer Medicine
ISSN: 2045-7634
Popis: Background A standard of care for pretreated, advanced non–small‐cell lung cancers (NSCLCs), nivolumab has demonstrated long‐term benefit when administered for 2 years. We aimed to better discern an optimized administration duration by retrospectively analyzing real‐life long‐term efficacy in a prospective cohort. Methods All nivolumab‐treated adults with advanced NSCLCs (01/09/2015 to 30/09/2016) from nine French centers were eligible. On 31/12/2018, patients who are alive ≥ 2 years after starting nivolumab were defined as long‐term survivors (LTSs) and were divided into three nivolumab treatment groups: 2 years. Co‐primary endpoints were LTSs’ progression‐free survival (PFS) and overall survival (OS). Results The median follow‐up was 32 months (95% CI, 31.0 to 34.0). The 3‐year OS rate for the 259 cohort patients was 16.6%. Among them, 65 were LTSs: 47 treated 2 years. Their respective characteristics were: median age: 59, 52, and 58 years; smoking history: 92.9, 100, and 100%; adenocarcinomas: 66, 57.1, and 54.5%. LTSs’ median (m)PFS was 28.4 months; mOS was not reached. LTSs’ objective response rate was 61.6%. mOS was 32.7 months for those treated 2‐year group's 3‐year OS was longer. Twenty‐eight LTSs experienced no disease progression; 7 had durable complete responses. However, LTSs had more frequent and more severe adverse events. Conclusion In real‐life, prolonged nivolumab use provided long‐term benefit with 16.6% 3‐year OS and 25% LTSs. Survival tended to be prolonged with nivolumab continued beyond 2 years. Prospective randomized trials with adequate design are needed.
Phase III trials didn't provide an optimal duration of immunotherapy for responder or stable patients in advanced non‐small‐cell lung cancer. A 2 years‐fixed duration or long‐term therapy are proposed to clinicians. The results of this observational study of 65 long‐term survivor pretreated patients showed a trends toward improvement of survival outcomes when continuing nivolumab after two years.
Databáze: OpenAIRE
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