Real-world survival outcomes with immune checkpoint inhibitors in large-cell neuroendocrine tumors of lung.
Real-world survival outcomes with immune checkpoint inhibitors in large-cell neuroendocrine tumors of lung.
- 2021
BACKGROUND: Little is known regarding the efficacy of immune checkpoint inhibitors (ICI) in patients with advanced large-cell neuroendocrine lung carcinoma (aLCNEC). CONCLUSIONS: With the limitations of retrospective design and small sample size, the results of this real-world cohort analysis suggest a positive impact of ICI on OS in aLCNEC. Copyright (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. METHODS: 125 consecutive patients with aLCNEC were identified in the electronic databases of 4 participating cancer centers. The patients were divided into group A (patients who received ICI, n=41) and group B (patients who did not receive ICI, n=84). Overall survival since advanced disease diagnosis (OS DX) and OS since ICI initiation (OS ICI) were captured. RESULTS: With a median follow-up of 11.8 months (mo) (IQR 7.5-17.9) and 6.0mo (IQR 3.1-10.9), 66% and 76% of patients died in groups A and B, respectively. Median OS DX was 12.4mo (95% CI 10.7 to 23.4) and 6.0mo (95% CI 4.7 to 9.4) in groups A and B, respectively (log-rank test, p=0.02). For ICI administration, HR for OS DX was 0.59 (95% CI 0.38 to 0.93, p=0.02-unadjusted), and 0.58 (95% CI 0.34 to 0.98, p=0.04-adjusted for age, Eastern Cooperative Oncology Group (ECOG) performance status (PS), presence of liver metastases and chemotherapy administration). In a propensity score matching analysis (n=74; 37 patients in each group matched for age and ECOG PS), median OS DX was 12.5 mo (95% CI 10.6 to 25.2) and 8.4 mo (95% CI 5.4 to 16.9) in matched groups A and B, respectively (log-rank test, p=0.046). OS ICI for patients receiving ICI as monotherapy (n=36) was 11.0 mo (95% CI 6.1 to 19.4).
English
2051-1426
10.1136/jitc-2020-001999 [doi] jitc-2020-001999 [pii]
*Carcinoma, Large Cell/dt [Drug Therapy]
*Carcinoma, Neuroendocrine/dt [Drug Therapy]
*Immune Checkpoint Inhibitors/tu [Therapeutic Use]
*Lung Neoplasms/dt [Drug Therapy]
Aged
Carcinoma, Large Cell/im [Immunology]
Carcinoma, Large Cell/mo [Mortality]
Carcinoma, Large Cell/sc [Secondary]
Carcinoma, Neuroendocrine/im [Immunology]
Carcinoma, Neuroendocrine/mo [Mortality]
Carcinoma, Neuroendocrine/sc [Secondary]
District of Columbia
Female
Humans
Immune Checkpoint Inhibitors/ae [Adverse Effects]
Israel
Lung Neoplasms/im [Immunology]
Lung Neoplasms/mo [Mortality]
Lung Neoplasms/pa [Pathology]
Male
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Tumor Microenvironment
MedStar Washington Hospital Center
Washington Cancer Institute
Medicine/Internal Medicine
Journal Article
BACKGROUND: Little is known regarding the efficacy of immune checkpoint inhibitors (ICI) in patients with advanced large-cell neuroendocrine lung carcinoma (aLCNEC). CONCLUSIONS: With the limitations of retrospective design and small sample size, the results of this real-world cohort analysis suggest a positive impact of ICI on OS in aLCNEC. Copyright (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. METHODS: 125 consecutive patients with aLCNEC were identified in the electronic databases of 4 participating cancer centers. The patients were divided into group A (patients who received ICI, n=41) and group B (patients who did not receive ICI, n=84). Overall survival since advanced disease diagnosis (OS DX) and OS since ICI initiation (OS ICI) were captured. RESULTS: With a median follow-up of 11.8 months (mo) (IQR 7.5-17.9) and 6.0mo (IQR 3.1-10.9), 66% and 76% of patients died in groups A and B, respectively. Median OS DX was 12.4mo (95% CI 10.7 to 23.4) and 6.0mo (95% CI 4.7 to 9.4) in groups A and B, respectively (log-rank test, p=0.02). For ICI administration, HR for OS DX was 0.59 (95% CI 0.38 to 0.93, p=0.02-unadjusted), and 0.58 (95% CI 0.34 to 0.98, p=0.04-adjusted for age, Eastern Cooperative Oncology Group (ECOG) performance status (PS), presence of liver metastases and chemotherapy administration). In a propensity score matching analysis (n=74; 37 patients in each group matched for age and ECOG PS), median OS DX was 12.5 mo (95% CI 10.6 to 25.2) and 8.4 mo (95% CI 5.4 to 16.9) in matched groups A and B, respectively (log-rank test, p=0.046). OS ICI for patients receiving ICI as monotherapy (n=36) was 11.0 mo (95% CI 6.1 to 19.4).
English
2051-1426
10.1136/jitc-2020-001999 [doi] jitc-2020-001999 [pii]
*Carcinoma, Large Cell/dt [Drug Therapy]
*Carcinoma, Neuroendocrine/dt [Drug Therapy]
*Immune Checkpoint Inhibitors/tu [Therapeutic Use]
*Lung Neoplasms/dt [Drug Therapy]
Aged
Carcinoma, Large Cell/im [Immunology]
Carcinoma, Large Cell/mo [Mortality]
Carcinoma, Large Cell/sc [Secondary]
Carcinoma, Neuroendocrine/im [Immunology]
Carcinoma, Neuroendocrine/mo [Mortality]
Carcinoma, Neuroendocrine/sc [Secondary]
District of Columbia
Female
Humans
Immune Checkpoint Inhibitors/ae [Adverse Effects]
Israel
Lung Neoplasms/im [Immunology]
Lung Neoplasms/mo [Mortality]
Lung Neoplasms/pa [Pathology]
Male
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Tumor Microenvironment
MedStar Washington Hospital Center
Washington Cancer Institute
Medicine/Internal Medicine
Journal Article