Salvage Immunotherapy With Pembrolizumab in Patients Hospitalized for Life-Threatening Complications of NSCLC
| Autor: | Alexis Benjamin Cortot, Xavier Dhalluin, Luc Stoven, Clément Gauvain, Ferréol Roborel de Climens, Vincent Leroy, Christos Chouaid, Claire Poulet |
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| Přispěvatelé: | CHU Lille, Université de Lille, Service de Pneumologie [CHI Créteil], CHI Créteil, IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Amiens-Picardie, Clinique Teissier (Valenciennes) (AHNAC), Centre Hospitalier Boulogne-sur-mer, Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 (CANTHER), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS) |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment Inpatient setting [SDV.CAN]Life Sciences [q-bio]/Cancer Pembrolizumab law.invention law Internal medicine Oxygen therapy medicine In patient Lung cancer RC254-282 Performance status business.industry Neoplasms. Tumors. Oncology. Including cancer and carcinogens Immunotherapy medicine.disease Intensive care unit Confidence interval Clinical alteration Oncology Original Article business |
| Zdroj: | JTO Clinical and Research Reports, Vol 2, Iss 5, Pp 100147-(2021) Jto Clinical and Research Reports Jto Clinical and Research Reports, 2021, 2 (5), pp.100147. ⟨10.1016/j.jtocrr.2021.100147⟩ JTO Clinical and Research Reports |
| ISSN: | 2666-3643 |
| Popis: | International audience; Introduction: It is not known whether patients with NSCLC who are hospitalized because of cancer-related complications are liable to benefit from salvage immunotherapy.Methods: This is a multicenter observational study including five centers, which involve all patients with advanced-stage NSCLC exhibiting a level of programmed death-ligand 1 (PD-L1) greater than or equal to 1%, having been hospitalized because of complications attributed to the evolution of the NSCLC, and having started pembrolizumab treatment during their hospitalization because of a risk of clinical deterioration in the short term. The analysis measured overall survival (OS) and the rate of discharge to home at 3 months.Results: The study included 33 patients, including 28 (85%) with metastatic NSCLC and 27 (82%) under first-line treatment. The main causes of hospitalization were deterioration of the general condition (52%), acute respiratory failure (18%), and an uncontrolled infection owing to the tumor (15%). A total of 20 patients (60%) had a performance status greater than or equal to 2 and 15 (45%) were under oxygen therapy. A total of 29 patients (88%) had a PD-L1 greater than or equal to 50%. Five patients (15%) started pembrolizumab in the intensive care unit. The median OS was 4.3 months (95% confidence interval [CI]: 0.9-not reached), and the 6-month and 1-year OS rates were 41.5% (95% CI: 27.5%-62.6%) and 32.6% (95% CI: 19.0%-55.9%), respectively. The home discharge rate at 3 months was 39% (95% CI: 23%-58%).Conclusions: Even when initiated in patients hospitalized for a life-threatening clinical deterioration, pembrolizumab seems to prolong the survival of certain patients with high PD-L1 NSCLC. Prospective, controlled data are necessary to confirm these results. |
| Databáze: | OpenAIRE |
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