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Role of pleural and peritoneal metastasis in immune checkpoint inhibitors efficacy patients with non-small cell lung cancer: real-world data from a large cohort in France

Journal of Cancer Research and Clinical Oncology volume 146, pages 2699–2707 (2020)Cite this article

Abstract

Background

Checkpoint inhibitors (CKI) targeting PD-1 or PD-L1 are major therapies for the treatment of non-small cell lung cancer (NSCLC). Despite numerous studies of biological biomarkers, we currently lack a marker to predict CKI primary resistance. The aim of this study was to isolate clinical markers associated with the absence of efficacy of CKI used as monotherapy in NSCLC.

Methods

We conducted a retrospective analysis of 172 patients treated with anti-PD1 or anti-PDL1 monoclonal antibodies (mAb) for advanced NSCLC at the Dijon Cancer Center. Baseline characteristics were compared using the Chi squared test between responders and non-responders. Survival curves were estimated by the Kaplan–Meier method and compared with the Log-rank test for univariate analysis. Cox regression models were used to determine hazard ratios and 95% confidence intervals for progression-free survival (PFS) and overall survival (OS).

Results

Among 172 patients included, 149 (86.5%) received CKI after platinum chemotherapy. Response rate (RR) was 16%, median progression-free survival (PFS) was 2.5 months (95% CI 0.7–30 months) and median overall survival (OS) was 10 months (95% CI 0.7–46.8 months). By univariate analysis, WHO performance status ≥ 1, presence of bone, liver and pleuroperitoneal metastasis were associated with poor PFS and OS. Multivariate analysis showed that only pleuroperitoneal metastasis was independently associated with PFS and OS. Patients with pleuroperitoneal metastasis and WHO performance status ≥ 1 had a < 10% chance of yielding a benefit from CKI.

Conclusions

Our data support the hypothesis that pleuroperitoneal metastasis is a major predictive factor affecting CKI efficacy in NSCLC patients and may be used to avoid CKI monotherapy for such patients.

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Funding

No Funding were requested for this study.

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Affiliations

  1. Department of Medical Oncology, Center Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France

    Anne Aarnink, Jean David Fumet, Laure Favier & Francois Ghiringhelli

  2. Research Platform in Biological Oncology, Dijon, France

    Jean David Fumet, Caroline Truntzer & Francois Ghiringhelli

  3. GIMI Genetic and Immunology Medical Institute, Dijon, France

    Jean David Fumet, Caroline Truntzer & Francois Ghiringhelli

  4. University of Burgundy-Franche Comté, Dijon, France

    Jean David Fumet & Francois Ghiringhelli

  5. UMR INSERM 1231, Dijon, France

    Jean David Fumet, Caroline Truntzer & Francois Ghiringhelli

Authors
  1. Anne Aarnink
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  2. Jean David Fumet
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  3. Laure Favier
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  4. Caroline Truntzer
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  5. Francois Ghiringhelli
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Correspondence to Francois Ghiringhelli.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration.

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Informed consent was obtained from all individual participants included in the study.

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Aarnink, A., Fumet, J.D., Favier, L. et al. Role of pleural and peritoneal metastasis in immune checkpoint inhibitors efficacy patients with non-small cell lung cancer: real-world data from a large cohort in France. J Cancer Res Clin Oncol 146, 2699–2707 (2020). https://doi.org/10.1007/s00432-020-03262-2

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  • DOI: https://doi.org/10.1007/s00432-020-03262-2

Keywords

  • Non-small cell lung cancer
  • Immunotherapy
  • Checkpoint inhibitors
  • Biomarkers