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Kano, Hirohisa Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
Ichihara, Eiki Department of Allergy and Respiratory Medicine, Okayama University Hospital Kaken ID publons
Harada, Daijiro Department of Thoracic Oncology, National Hospital Organization Shikoku Cancer Center
Inoue, Koji Department of Respiratory Medicine, Ehime Prefectural Central Hospital
Kayatani, Hiroe Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center
Hosokawa, Shinobu Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital
Kishino, Daizo Department of Respiratory Medicine, Himeji Red Cross Hospital
Watanabe, Kazuhiko Department of Internal Medicine, Okayama Saiseikai General Hospital
Ochi, Nobuaki Department of General Internal Medicine 4, Kawasaki Medical School
Oda, Naohiro Department of Internal Medicine, Fukuyama City Hospital
Hara, Naofumi Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
Ninomiya, Kiichiro Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
Hotta, Katsuyuki Center for Innovative Clinical Medicine, Okayama University Hospital Kaken ID publons researchmap
Maeda, Yoshinobu Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Kaken ID researchmap
Kiura, Katsuyuki Department of Allergy and Respiratory Medicine, Okayama University Hospital ORCID Kaken ID publons researchmap
Abstract
Most clinical trials of non-small-cell lung cancer (NSCLC) exclude patients with poor ECOG performance status (PS). Thus, the efficacy of immune checkpoint inhibitors (ICIs) in patients with poor PS remains unclear. Herein, we used data from a retrospective cohort to assess the potential clinical benefits of ICIs in NSCLC patients with poor PS. Data from NSCLC patients who received ICI monotherapy at 9 institutions between December 2015 and May 2018 were retrospectively analyzed. After excluding 4 patients who lacked PS data, a total of 527 ICI-treated patients, including 79 patients with PS 2 or higher, were used for our analyses. The progression-free survival (PFS) and overall survival (OS) of patients with PS 2 or higher were significantly shorter compared with those of PS 0-1 patients (median PFS, 4.1 vs 2.0 months;P < .001 and median OS, 17.4 vs 4.0 months;P < .001). Among NSCLC patients with programmed cell death protein-ligand 1 (PD-L1) expression of 50% or higher who were treated with pembrolizumab as first-line therapy, the median PFS times of patients with PS 2 and 0-1 were 7.3 and 8.1 months, respectively. There was no significant difference in PFS between patients with PS 2 and 0-1 (P = .321). Although poor PS was significantly associated with worse outcomes in NSCLC patients treated with ICIs, pembrolizumab as a first-line treatment in NSCLC patients expressing high levels of PD-L1 could provide a clinical benefit, even in patients with PS 2.
Keywords
immune checkpoint inhibitor
non-small cell-lung cancer
PD-L1
pembrolizumab
poor performance status
Published Date
2020-07-29
Publication Title
Cancer Science
Volume
volume111
Issue
issue10
Publisher
Wiley
Start Page
3739
End Page
3746
ISSN
1347-9032
NCID
AA11808050
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
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© 2020 The Authors.
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isVersionOf https://doi.org/10.1111/cas.14590
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https://creativecommons.org/licenses/by-nc/4.0/