Efficacy of immune checkpoint inhibitors in non-small cell lung cancer with uncommon histology: a propensity-score-matched analysis

BMC Pulmonary Medicine

Naoki Inui¹  Shun Matsuura²  Mitsuru Niwa³  Mikio Toyoshima⁴  Keigo Koda⁴  Sayomi Matsushima⁵  Hiroyuki Matsuda⁶  Masato Kono⁷  Takashi Matsui⁸  Masato Fujii⁹  Kazuhiro Asada^1,10  Hideki Kusagaya^1,11  Yuzo Suzuki^1,12  Takafumi Suda^1,12  Hironao Hozumi^1,12  Noriyuki Enomoto^1,12  Kazuki Furuhashi^1,12  Koichi Miyashita^1,12  Masato Karayama^1,12  Tomoyuki Fujisawa^1,12  Yusuke Inoue^1,12  Yutaro Nakamura^1,13 

[1] Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, 1-20-1 Handayama, 431-3192, Hamamatsu, Japan;Department of Respiratory Medicine, Fujieda Municipal General Hospital, 4-1-11 Surugadai, 426-8677, Fujieda, Japan;Department of Respiratory Medicine, Hamamatsu Medical Center, 328 Tomitsuka-cho, 432-8580, Hamamatsu, Japan;Department of Respiratory Medicine, Hamamatsu Rosai Hospital, 25 Shougen-cho, 430-8525, Hamamatsu, Japan;Department of Respiratory Medicine, Iwata City Hospital, 513-2 Ohkubo, 438-8550, Iwata, Japan;Department of Respiratory Medicine, Japanese Red Cross Shizuoka Hospital, 8-2 Otemachi, 420-0853, Shizuoka, Japan;Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, 430-8558, Hamamatsu, Japan;Department of Respiratory Medicine, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, 433-8558, Hamamatsu, Japan;Department of Respiratory Medicine, Shizuoka City Hospital, 10-93 Ote-cho, 420-8630, Shizuoka, Japan;Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-ando, 420-0881, Shizuoka, Japan;Department of Respiratory Medicine, Shizuoka Saiseikai Hospital, 1-1-1 Oshika, 422- 8527, Shizuoka, Japan;Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, 431-3192, Hamamatsu, Japan;Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, 431-3192, Hamamatsu, Japan;Department of Chemotherapy, Hamamatsu University School of Medicine, 1-20-1 Handayama, 431-3192, Hamamatsu, Japan;

关键词: Pleomorphic carcinoma;    Large cell neuroendocrine carcinoma;    Not otherwise specified;    Programmed death-1;    Programmed death ligand-1;   

DOI  :  10.1186/s12890-021-01681-6

来源: Springer

【 摘 要 】

BackgroundClinical efficacy of immune checkpoint inhibitors (ICIs) for non-small cell lung cancer (NSCLC) with uncommon histology (uNSCLC) is unknown.MethodsPatients with NSCLC treated with ICI monotherapy between January 2014 and December 2018 in 10 Japanese hospitals were retrospectively evaluated. The patients were divided into: (1) NSCLC with common histology (cNSCLC), defined as adenocarcinoma and squamous cell carcinoma; and (2) uNSCLC, defined as incompatibility with morphological and immunohistochemical criteria for adenocarcinoma or squamous cell carcinoma. Propensity score matching was performed to balance the two groups.ResultsAmong a total of 175 patients included, 44 with uNSCLC (10 pleomorphic carcinomas, 9 large cell neuroendocrine carcinomas, 2 large cell carcinomas, and 23 not otherwise specified) and 44 with matched cNSCLC (32 adenocarcinomas and 12 squamous cell carcinomas) were selected for analyses. Median progression-free survival (PFS) (4.4 months, 95% confidence interval [CI] 1.8–7.7 months) and overall survival (OS) (11.4 months, 95% CI 7.4–27.4 months) in the uNSCLC patients were not significantly different from those in matched cNSCLC patients (5.4 months, 95% CI 3.1–7.6 months, p = 0.761; and 14.1 months, 95% CI 10.6–29.6 months, p = 0.381). In multivariate analysis, Eastern Cooperative Oncology Group performance status (ECOG-PS) of 0–1 and programmed death ligand-1 (PD-L1) expression were predictive for PFS and OS in uNSCLC.ConclusionsICIs had similar clinical efficacy for treatment of uNSCLC and cNSCLC. Good ECOG-PS and PD-L1 expression were predictive for efficacy of ICIs in uNSCLC.

【 授权许可】

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