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Journal of Cancer Research and Clinical Oncology

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26.11.2021 | Original Article – Clinical Oncology

Impact of maintenance therapy following induction immunochemotherapy for untreated advanced non-small cell lung cancer patients

verfasst von: Ryota Nakamura, Tadaaki Yamada, Kenji Morimoto, Akira Nakao, Yasuhiro Goto, Yuri Ogura, Takayuki Takeda, Chieko Takumi, Keisuke Onoi, Yusuke Chihara, Ryusuke Taniguchi, Takahiro Yamada, Osamu Hiranuma, Satomi Tanaka, Yoshie Morimoto, Masahiro Iwasaku, Shinsaku Tokuda, Yoshiko Kaneko, Junji Uchino, Koichi Takayama

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 11/2022

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Abstract

Purpose

The primary objective of this study was to identify the potential predictors to assess the impact of maintenance therapy after induction immunochemotherapy in the real-world setting of patients with advanced non-small cell lung cancer (NSCLC).

Methods

We retrospectively identified 152 patients with advanced NSCLC who received immunochemotherapy at 8 hospitals in Japan between January 2019 and December 2019. Patients who received at least four cycles of induction immunochemotherapy and one cycle of maintenance therapy with immune checkpoint inhibitors were included. We investigated the biomarkers for progression-free survival (PFS) for maintenance therapy after induction immunochemotherapy.

Results

Out of the 92 patients with advanced NSCLC included in the study, 42 received maintenance therapy with cytotoxic agents, whereas 50 received maintenance therapy without cytotoxic agents. Among those who received maintenance therapy without cytotoxic agents, responders to prior immunochemotherapy had significantly longer PFS than non-responders (p = 0.004), except those with maintenance therapy with cytotoxic agents. In non-responders to prior immunochemotherapy, patients with maintenance therapy with cytotoxic agents had significantly longer PFS than those with maintenance therapy without cytotoxic agents (log-rank p = 0.007), whereas, among responders to prior immunochemotherapy, there was no significant difference in PFS for different maintenance regimens (log-rank p = 0.31).

Conclusions

This retrospective study showed that response to prior immunochemotherapy was associated with clinical outcomes among patients with advanced NSCLC who received maintenance therapy.

Akamatsu H, Ninomiya K, Kenmotsu H et al (2019) The Japanese Lung Cancer Society Guideline for non-small cell lung cancer, stage IV. Int J Clin Oncol 24:731–770. https://doi.org/10.1007/s10147-019-01431-zCrossRefPubMedPubMedCentral

Bracci L, Schiavoni G, Sistigu A, Belardelli F (2014) Immune-based mechanisms of cytotoxic chemotherapy: Implications for the design of novel and rationale-based combined treatments against cancer. Cell Death Differ 21:15–25. https://doi.org/10.1038/cdd.2013.67CrossRefPubMed

Bray F, Ferlay J, Soerjomataram I et al (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424. https://doi.org/10.3322/caac.21492CrossRefPubMed

de Rouw N, Boosman RJ, van de Bruinhorst H et al (2020) Cumulative pemetrexed dose increases the risk of nephrotoxicity. Lung Cancer 146:30–35. https://doi.org/10.1016/j.lungcan.2020.05.022CrossRefPubMed

Diem S, Schmid S, Krapf M et al (2017) Neutrophil-to-lymphocyte ratio (NLR) and Platelet-to-Lymphocyte ratio (PLR) as prognostic markers in patients with non-small cell lung cancer (NSCLC) treated with nivolumab. Lung Cancer 111:176–181. https://doi.org/10.1016/j.lungcan.2017.07.024CrossRefPubMed

Dumoulin DW, Visser S, Cornelissen R et al (2020) Renal toxicity from pemetrexed and pembrolizumab in the era of combination therapy in patients with metastatic nonsquamous cell NSCLC. J Thorac Oncol 15:1472–1483. https://doi.org/10.1016/j.jtho.2020.04.021CrossRefPubMed

Ettinger DS, Aisner DL, Wood DE et al (2018) NCCN Guidelines insights: non-small cell lung cancer, version 5.2018. J Natl Compr Canc Netw 16:807–821. https://doi.org/10.6004/jnccn.2018.0062CrossRefPubMed

Gadgeel S, Rodríguez-Abreu D, Speranza G et al (2020) Updated analysis from KEYNOTE-189: Pembrolizumab or placebo plus pemetrexed and platinum for previously untreated metastatic nonsquamous non-small-cell lung cancer. J Clin Oncol 38:1505–1517. https://doi.org/10.1200/JCO.19.03136CrossRefPubMed

Gandhi L, Rodríguez-Abreu D, Gadgeel S et al (2018) Pembrolizumab plus chemotherapy in metastatic non-small-cell lung cancer. N Engl J Med 378:2078–2092. https://doi.org/10.1056/NEJMoa1801005CrossRefPubMed

Garon EB, Hellmann MD, Rizvi NA et al (2019) Five-year overall survival for patients with advanced non-small-cell lung cancer treated with pembrolizumab: Results from the Phase I KEYNOTE-001 study. J Clin Oncol 37:2518–2527. https://doi.org/10.1200/JCO.19.00934CrossRefPubMedPubMedCentral

Hellmann MD, Paz-Ares L, Bernabe Caro R et al (2019) Nivolumab plus ipilimumab in advanced Non–small-cell lung cancer. N Engl J Med 381:2020–2031. https://doi.org/10.1056/NEJMoa1910231CrossRefPubMed

Kanda Y (2013) Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 48:452–458. https://doi.org/10.1038/bmt.2012.244CrossRefPubMed

Paz-Ares L, de Marinis F, Dediu M et al (2012) Maintenance therapy with pemetrexed plus best supportive care versus placebo plus best supportive care after induction therapy with pemetrexed plus cisplatin for advanced non-squamous non-small-cell lung cancer (Paramount): a double-blind, phase 3, randomised controlled trial. Lancet Oncol 13:247–255. https://doi.org/10.1016/S1470-2045(12)70063-3CrossRefPubMed

Paz-Ares LG, de Marinis F, Dediu M et al (2013) Paramount: final overall survival results of the phase III study of maintenance pemetrexed versus placebo immediately after induction treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancer. J Clin Oncol 31:2895–2902. https://doi.org/10.1200/JCO.2012.47.1102CrossRefPubMed

Paz-Ares L, Luft A, Vicente D et al (2018) Pembrolizumab plus chemotherapy for squamous Non–small-cell lung cancer. N Engl J Med 379:2040–2051. https://doi.org/10.1056/NEJMoa1810865CrossRefPubMed

Paz-Ares L, Ciuleanu TE, Cobo M et al (2021) First-line nivolumab plus ipilimumab combined with two cycles of chemotherapy in patients with non-small-cell lung cancer (CheckMate 9LA): an international, randomised, open-label, phase 3 trial. Lancet Oncol 22:198–211. https://doi.org/10.1016/S1470-2045(20)30641-0CrossRefPubMed

Planchard D, Popat S, Kerr K et al (2018) Metastatic non-small cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 29:iv192–iv237. https://doi.org/10.1093/annonc/mdy275CrossRefPubMed

Roselli M, Cereda V, di Bari MG et al (2013) Effects of conventional therapeutic interventions on the number and function of regulatory T cells. Oncoimmunology 2:e27025. https://doi.org/10.4161/onci.27025CrossRefPubMedPubMedCentral

Socinski MA, Jotte RM, Cappuzzo F et al (2018) Atezolizumab for first-line treatment of metastatic nonsquamous NSCLC. N Engl J Med 378:2288–2301. https://doi.org/10.1056/NEJMoa1716948CrossRefPubMed

Visser S, Huisbrink J, van’t Veer NE et al (2018) Renal impairment during pemetrexed maintenance in patients with advanced nonsmall cell lung cancer: a cohort study. Eur Respir J. https://doi.org/10.1183/13993003.00884-2018CrossRefPubMed

Wang Z, Till B, Gao Q (2017) Chemotherapeutic agent-mediated elimination of myeloid-derived suppressor cells. Oncoimmunology 6:e1331807. https://doi.org/10.1080/2162402X.2017.1331807CrossRefPubMedPubMedCentral

West H, McCleod M, Hussein M et al (2019) Atezolizumab in combination with carboplatin plus nab-paclitaxel chemotherapy compared with chemotherapy alone as first-line treatment for metastatic non-squamous non-small-cell lung cancer (IMpower130): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol 20:924–937. https://doi.org/10.1016/S1470-2045(19)30167-6CrossRefPubMed

Ye J, Ji X, Dennis PA et al (2020) Relationship between progression-free survival, objective response rate, and overall survival in clinical trials of PD-1/PD-L1 immune checkpoint blockade: a meta-analysis. Clin Pharmacol Ther 108:1274–1288. https://doi.org/10.1002/cpt.1956CrossRefPubMedPubMedCentral

Titel: Impact of maintenance therapy following induction immunochemotherapy for untreated advanced non-small cell lung cancer patients
verfasst von: Ryota Nakamura
Tadaaki Yamada
Kenji Morimoto
Akira Nakao
Yasuhiro Goto
Yuri Ogura
Takayuki Takeda
Chieko Takumi
Keisuke Onoi
Yusuke Chihara
Ryusuke Taniguchi
Takahiro Yamada
Osamu Hiranuma
Satomi Tanaka
Yoshie Morimoto
Masahiro Iwasaku
Shinsaku Tokuda
Yoshiko Kaneko
Junji Uchino
Koichi Takayama
Publikationsdatum: 26.11.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 11/2022
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-021-03866-2

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Impact of maintenance therapy following induction immunochemotherapy for untreated advanced non-small cell lung cancer patients