Smoking status during first-line immunotherapy and chemotherapy in NSCLC patients: A case-control matched analysis from a large multicenter study

Autor: Maria Vittoria Pensieri, Ettore D'Argento, Giovanni Mansueto, Lorenza Landi, Mario Occhipinti, Diego Cortinovis, Robin Cornelissen, Diego Signorelli, Lorenzo Antonuzzo, Gabriele Minuti, Valerio Maria Napoli, Corrado Ficorella, Francesco Grossi, Raffaele Giusti, Cinzia Baldesarri, Vincenzo Di Noia, Giampiero Porzio, Alfredo Addeo, Luigi Della Gravara, Vincenzo Sforza, Serena Ricciardi, Paola Bordi, Francesca Rastelli, Alessandro Inno, Giuseppe Luigi Banna, Giovanni Rossi, Michele De Tursi, Matteo Santoni, Rita Chiari, Alessandro De Toma, Olga Nigro, Andrea De Giglio, Clelia Donisi, Luca Cantini, Fabrizio Citarella, Alessio Cortellini, Michele Montrone, Alain Gelibter, Gianmarco Leone, Alessandro Follador, Annamaria Catino, Federica Zoratto, Marco Filetti, Pietro Di Marino, Giulio Metro, Alex Friedlaender, Alessandro Leonetti, Rossana Berardi, Maria Rita Migliorino, Marco Russano, Katia Cannita
Přispěvatelé: Pulmonary Medicine, Cortellini A., De Giglio A., Cannita K., Cortinovis D.L., Cornelissen R., Baldessari C., Giusti R., D'Argento E., Grossi F., Santoni M., Catino A., Berardi R., Sforza V., Rossi G., Antonuzzo L., Di Noia V., Signorelli D., Gelibter A., Occhipinti M.A., Follador A., Rastelli F., Chiari R., Gravara L.D., Inno A., De Tursi M., Di Marino P., Mansueto G., Zoratto F., Filetti M., Montrone M., Citarella F., Pensieri M.V., Russano M., Cantini L., Nigro O., Leonetti A., Bordi P., Minuti G., Landi L., De Toma A., Donisi C., Ricciardi S., Migliorino M.R., Napoli V.M., Leone G., Metro G., Banna G.L., Friedlaender A., Addeo A., Ficorella C., Porzio G.
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
non‐small cell lung cancer
0301 basic medicine
Pulmonary and Respiratory Medicine
Oncology
medicine.medical_specialty
Lung Neoplasms
medicine.medical_treatment
First line
Respiratory System
Pembrolizumab
immunotherapy
non-small cell lung cancer
pembrolizumab
smoking
tobacco
lcsh:RC254-282
03 medical and health sciences
0302 clinical medicine
SDG 3 - Good Health and Well-being
Carcinoma
Non-Small-Cell Lung
Internal medicine
medicine
Humans
Chemotherapy
Science & Technology
business.industry
Hazard ratio
Original Articles
General Medicine
Immunotherapy
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Former Smoker
Survival Analysis
Lung Neoplasm
030104 developmental biology
Case-Control Studies
030220 oncology & carcinogenesis
Cohort
Female
Original Article
Smoking status
Case-Control Studie
business
Life Sciences & Biomedicine
Human
Zdroj: Thoracic Cancer, Vol 12, Iss 6, Pp 880-889 (2021)
Thoracic Cancer, 12(6), 880-889. Blackwell Publishing
Thoracic Cancer
ISSN: 1759-7714
1759-7706
Popis: Background Improved outcome in tobacco smoking patients with non‐small cell lung cancer (NSCLC) following immunotherapy has previously been reported. However, little is known regarding this association during first‐line immunotherapy in patients with high PD‐L1 expression. In this study we compared clinical outcomes according to the smoking status of two large multicenter cohorts. Methods We compared clinical outcomes according to the smoking status (never smokers vs. current/former smokers) of two retrospective multicenter cohorts of metastatic NSCLC patients, treated with first‐line pembrolizumab and platinum‐based chemotherapy. Results A total of 962 NSCLC patients with PD‐L1 expression ≥50% who received first‐line pembrolizumab and 462 NSCLC patients who received first‐line platinum‐based chemotherapy were included in the study. Never smokers were confirmed to have a significantly higher risk of disease progression (hazard ratio [HR] = 1.49 [95% CI: 1.15–1.92], p = 0.0022) and death (HR = 1.38 [95% CI: 1.02–1.87], p = 0.0348) within the pembrolizumab cohort. On the contrary, a nonsignificant trend towards a reduced risk of disease progression (HR = 0.74 [95% CI: 0.52–1.05], p = 0.1003) and death (HR = 0.67 [95% CI: 0.45–1.01], p = 0.0593) were reported for never smokers within the chemotherapy cohort. After a random case–control matching, 424 patients from both cohorts were paired. Within the matched pembrolizumab cohort, never smokers had a significantly shorter progression‐free survival (PFS) (HR = 1.68 [95% CI: 1.17–2.40], p = 0.0045) and a nonsignificant trend towards a shortened overall survival (OS) (HR = 1.32 [95% CI: 0.84–2.07], p = 0.2205). On the contrary, never smokers had a significantly longer PFS (HR = 0.68 [95% CI: 0.49–0.95], p = 0.0255) and OS (HR = 0.66 [95% CI: 0.45–0.97], p = 0,0356) compared to current/former smoker patients within the matched chemotherapy cohort. On pooled multivariable analysis, the interaction term between smoking status and treatment modality was concordantly statistically significant with respect to ORR (p = 0.0074), PFS (p = 0.0001) and OS (p = 0.0020), confirming the significantly different impact of smoking status across the two cohorts. Conclusions Among metastatic NSCLC patients with PD‐L1 expression ≥50% receiving first‐line pembrolizumab, current/former smokers experienced improved PFS and OS. On the contrary, worse outcomes were reported among current/former smokers receiving first‐line chemotherapy.
Improved outcome in tobacco smoking NSCLC patients following treatment with immune checkpoint inhibitors (ICIs) has previously been reported. Little is known regarding this association during first‐line immunotherapy in patients with high PD‐L1 expression. Clinical outcomes according to the smoking status of two large multicenter cohorts were compared in this study. Smokers with high PD‐L1 expression ≥ 50% experienced improved progression‐free survival (PFS) and overall survival (OS) with first‐line pembrolizumab. The opposite trend was found in NSCLC patients treated with first‐line platinum‐based chemotherapy.
Databáze: OpenAIRE
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