Real-world survival outcomes with immune checkpoint inhibitors in large-cell neuroendocrine tumors of lung.

MedStar author(s):
Citation: Journal for Immunotherapy of Cancer. 9(2), 2021 02.PMID: 33597218Institution: MedStar Washington Hospital Center | Washington Cancer InstituteDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *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 MicroenvironmentYear: 2021ISSN:
  • 2051-1426
Name of journal: Journal for immunotherapy of cancerAbstract: 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).All authors: Bar J, Dudnik E, Gottfried T, Israel Lung Cancer Group, Kareff S, Kim C, Liu SV, Lobachov A, Moskovitz M, Onn A, Rotem O, Urban D, Wollner M, Zer AOriginally published: Journal for Immunotherapy of Cancer. 9(2), 2021 Feb.Fiscal year: FY2021Fiscal year of original publication: FY2021Digital Object Identifier: ORCID: Date added to catalog: 2021-03-10
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Journal Article MedStar Authors Catalog Article 33597218 Available 33597218

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).

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