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免疫相关不良事件与阿替利珠单抗在既往治疗的晚期非小细胞肺癌患者中的疗效关联:单中心经验

The Association of Immune-Related Adverse Events with the Efficacy of Atezolizumab in Previously Treated Advanced Non-Small-Cell Lung Cancer Patients: A Single-Center Experience.

作者信息

Marković Filip, Stjepanović Mihailo, Samardžić Natalija, Kontić Milica

机构信息

Clinic for Pulmonology, University Clinical Center of Serbia, 11000 Belgrade, Serbia.

Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.

出版信息

Cancers (Basel). 2024 Aug 28;16(17):2995. doi: 10.3390/cancers16172995.

Abstract

Immune checkpoint inhibitors (ICIs) are pivotal in managing metastatic non-oncogene addicted non-small-cell lung cancer (NSCLC). They have unique toxicities known as immune-related adverse events (irAEs). Previous studies have linked irAEs during atezolizumab-based first-line treatments in advanced NSCLC with improved outcomes. This study explored the association between irAEs and the efficacy of atezolizumab in advanced NSCLC patients who had previously received platinum-based chemotherapy. The study involved 105 advanced NSCLC patients who received atezolizumab monotherapy after progressing on at least one line of platinum-based chemotherapy from a single academic institution in Serbia. Data were obtained from a hospital lung cancer registry. Among the participants, 63.8% were male, with the majority being current (53.3%) or former smokers (37.1%). About half had a good performance status (ECOG PS 0-1) at the start of atezolizumab treatment. irAEs occurred in 23 patients (21.9%). The median progression-free survival (mPFS) was significantly longer for patients with irAEs (13.03 months) compared to those without (3.4 months) (HR 0.365 [95% CI, 0.195-0.681], = 0.002). irAEs and ECOG PS 0-1 were predictors of longer mPFS, with irAEs being more common in patients with good performance status ( = 0.01). irAEs were linked to improved mPFS in NSCLC patients treated with atezolizumab after multiple lines of platinum-based chemotherapy.

摘要

免疫检查点抑制剂(ICIs)在转移性非癌基因成瘾性非小细胞肺癌(NSCLC)的治疗中起着关键作用。它们具有独特的毒性,称为免疫相关不良事件(irAEs)。先前的研究将晚期NSCLC患者基于阿替利珠单抗的一线治疗期间的irAEs与更好的治疗结果联系起来。本研究探讨了irAEs与先前接受铂类化疗的晚期NSCLC患者使用阿替利珠单抗疗效之间的关联。该研究纳入了105例晚期NSCLC患者,这些患者在塞尔维亚的一个学术机构接受了至少一线铂类化疗进展后接受阿替利珠单抗单药治疗。数据来自医院肺癌登记处。参与者中,63.8%为男性,大多数为当前吸烟者(53.3%)或既往吸烟者(37.1%)。约一半患者在开始阿替利珠单抗治疗时具有良好的体能状态(ECOG PS 0-1)。23例患者(21.9%)发生了irAEs。与未发生irAEs的患者(3.4个月)相比,发生irAEs的患者的中位无进展生存期(mPFS)显著更长(13.03个月)(HR 0.365 [95% CI,0.195-0.681],P = 0.002)。irAEs和ECOG PS 0-1是mPFS更长的预测因素,irAEs在体能状态良好的患者中更常见(P = 0.01)。在接受多线铂类化疗后使用阿替利珠单抗治疗的NSCLC患者中,irAEs与mPFS改善相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5245/11394052/2f6962ea3548/cancers-16-02995-g001.jpg

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