Abstract
Purpose
The effect of immuno-chemotherapy on patients with advanced non-small-cell lung cancer (NSCLC) harboring oncogenic mutations remains poorly understood. This study aimed to characterize the efficacy of immuno-chemotherapy and determine the optimal treatment strategy for such patients.
Methods
We conducted this retrospective cohort study on patients with NSCLC harboring oncogenic driver alterations and treated with an immune checkpoint inhibitor combined with chemotherapy at five institutions. The clinical characteristics and outcomes of immuno-chemotherapy for NSCLC with oncogenic mutations in a real-world setting were analyzed.
Results
Among 846 patients diagnosed with advanced or recurrent NSCLC between April 2017 and April 2021, 43 patients with oncogenic mutations were treated with immuno-chemotherapy. The median age of patients was 68 (range 44–78) years; 42% of patients never smoked, and adenocarcinoma was the most common histology (95%). In patients with KRAS mutations (n = 10) or PD-L1 expression of 50% or greater (n = 10), the disease control rate was 100%. The median progression-free survival (PFS) was 5.4, 6.3, and 8.9 months in patients harboring mutations in EGFR, KRAS, and other genes, respectively (P = 0.22). Patients with PD-L1 expression of 50% or greater had significantly longer median PFS than patients with PD-L1 expression of less than 50% (16.4 vs. 5.1 months; P = 0.001). Two patients experienced grade 3 immuno-related adverse events.
Conclusion
Immuno-chemotherapy has a clinical benefit and is safe for patients with oncogenic mutations. Notably, patients with PD-L1 expression of 50% or more experience greater benefit from immuno-chemotherapy than those with PD-L1 expression of less than 50%.
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Data availability
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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TH: conceptualization, data curation, investigation, writing, and editing. CS: project administration, investigation, writing—review. KH: formal analysis and methodology. HK, MI, TN, YT, NT, SS, TT, TY, TY, MT: investigation. YN: supervision.
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Dr. Yamada received honoraria from Eli Lilly Japan K.K. and research funding from ONO Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., CHUGAI Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., and Pfizer Inc. All other authors declare no conflicts of interest.
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This study was approved by the institutional review committee of each participating hospital. (the Institutional Review Board of Rakuwakai Otowa Hospital, the Medical Ethics Committee of Kurashiki Central Hospital, the Ethics Review Board of the Kyoto Prefectural University of Medicine, the Ethics Review Committee of Japanese Red Cross Kyoto Daini Hospital, and the Ethics Review Committee of Japanese Red Cross Kyoto Daiichi Hospital).
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Hata, T., Sakaguchi, C., Hirano, K. et al. Efficacy and safety of immuno-chemotherapy in patients with advanced non-small-cell lung cancer harboring oncogenic mutations: a multicenter retrospective study. J Cancer Res Clin Oncol 149, 2475–2482 (2023). https://doi.org/10.1007/s00432-022-04125-8
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DOI: https://doi.org/10.1007/s00432-022-04125-8