Real-world 5-year overall survival in patients with metastatic non-small cell lung cancer and high PD-L1 expression treated by mono-immunotherapy

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Abstract

Background. The efficacy of immunotherapy in patients with metastatic non-small cell lung cancer correlates with PD-L1 expression in clinical trials.

Aim. To evaluate real-world overall survival (OS) in patients with PD-L1 expression scores 50–89 % and 90–100 % who received immunotherapy as the 1st line treatment.

Materials and methods. This real-world single-site retrospective study included patients with metastatic non-small cell lung cancer without driving EGFR / ALK mutations and high PD-L1 expression score (50–100 %) who received anti-PD-1 / PD-L1 mono-immunotherapy at the N. N. Blokhin National Research Medical Center of Oncology (2015–2022). Primary endpoint was OS.

Results. The study included 28 patients. Median follow-up duration was 66.15 months. Median OS for patients with PD-L1 expression 50–89 % was 34.4 months (95 % confidence interval 24.3–44.4). The 5-year OS for patients with PD-L1 expression 90–100 % was 70.1 % versus 17.6 % in patients with PD-L1 expression 50–89 % (hazard ratio 0.26 (95 % confidence interval 0.07–0.9)).

Conclusion. PD-L1 expression score 90–100 % was associated with better five-year outcomes for mono-immunotherapy in 1st line treatment.

About the authors

Denis I. Yudin

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: yudinden@mail.ru
ORCID iD: 0000-0002-0620-2696
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

K. K. Laktionov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: yudinden@mail.ru
ORCID iD: 0000-0003-4469-502X
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522; 1 Ostrovityanova St., Moscow, 117513

V. V. Breder

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: yudinden@mail.ru
ORCID iD: 0000-0002-6244-4294
Russian Federation, 24 Kashirskoe Shosse, Moscow, 115522

References

  1. Keir M.E., Butte M.J., Freeman G.J., Sharpe A.H. PD-1 and its ligands in tolerance and immunity. Annu Rev Immunol 2008;26:677–704. doi: 10.1146/annurev.immunol.26.021607.090331
  2. Gettinger S., Horn L., Jackman D. et al. Five-year follow-up of nivolumab in previously treated advanced non-small-cell lung cancer: results from the CA209-003 study. J Clin Oncol 2018;36(17):1675–84. doi: 10.1200/JCO.2017.77.0412
  3. Borghaei H., Gettinger S., Vokes E.E. et al. Five-year outcomes from the randomized, phase III trials CheckMate 017 and 057: nivolumab versus docetaxel in previously treated non-small-cell lung cancer. J Clin Oncol 2021;39(7):723–33. doi: 10.1200/JCO.20.01605. Erratum in: J Clin Oncol 2021;39(10):1190. doi: 10.1200/JCO.21.00546
  4. Herbst R.S., Garon E.B., Kim D.W. et al. Five year survival update from KEYNOTE-010: pembrolizumab versus docetaxel for previously treated, programmed death-ligand 1-positive advanced NSCLC. J Thorac Oncol 2021;16(10):1718–32. doi: 10.1016/j.jtho.2021.05.001
  5. Mazieres J., Rittmeyer A., Gadgeel S. et al. Atezolizumab versus docetaxel in pretreated patients with NSCLC: final results from the randomized phase 2 POPLAR and phase 3 OAK clinical trials. J Thorac Oncol 2021;16(1):140–50. doi: 10.1016/j.jtho.2020.09.022
  6. Reck M., Rodríguez-Abreu D., Robinson A.G. et al. Five-year outcomes with pembrolizumab versus chemotherapy for metastatic non-small-cell lung cancer with PD-L1 tumor proportion score ≥50. J Clin Oncol 2021;39(21):2339–49. doi: 10.1200/JCO.21.00174
  7. Garon E.B., Hellmann M.D., Rizvi N.A. et al. 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 2019;37(28):2518–27. doi: 10.1200/JCO.19.00934
  8. De Castro G. Jr, Kudaba I., Wu Y.L. et al. Five-year outcomes with pembrolizumab versus chemotherapy as first-line therapy in patients with non-small-cell lung cancer and programmed death ligand-1 tumor proportion score ≥1 % in the KEYNOTE-042 study. J Clin Oncol 2023;41(11):1986–91. doi: 10.1200/JCO.21.02885
  9. Rizvi N.A., Cho B.C., Reinmuth N. et al.; MYSTIC Investigators. durvalumab with or without tremelimumab versus standard chemotherapy in first-line treatment of metastatic non-small cell lung cancer: the MYSTIC phase 3 randomized clinical trial. JAMA Oncol 2020;6(5):661–74. doi: 10.1001/jamaoncol.2020.0237. Erratum in: JAMA Oncol 2020;6(11):1815. doi: 10.1001/jamaoncol.2020.5538
  10. Carbone D.P., Reck M., Paz-Ares L. et al.; CheckMate 026 Investigators. First-line nivolumab in stage IV or recurrent non-small-cell lung cancer. N Engl J Med 2017;376(25):2415–26. doi: 10.1056/NEJMoa1613493
  11. Herbst R.S., Giaccone G., de Marinis F. et al. Atezolizumab for first-line treatment of PD-L1-selected patients with NSCLC. N Engl J Med 2020;383(14):1328–39. doi: 10.1056/NEJMoa1917346
  12. Morita M., Tamiya M., Fujimoto D. et al. Prediction of patients with a tumor proportion score >50 % who do not respond to first-line monotherapy with pembrolizumab. BMC Cancer 2020;20(1):93. doi: 10.1186/s12885-020-6582-4
  13. Shah M., Hubbard R.A., Mamtani R. et al. Very high PD-L1 expression as a prognostic indicator of overall survival among patients with advanced non-small cell lung cancer receiving anti-PD-(L)1 monotherapies in routine practice. Pharmacoepidemiol Drug Saf 2022;31(10):1121–6. doi: 10.1002/pds.5487
  14. Jackson A., Chang N., Akurang D. et al. Real-world immunotherapy use and effectiveness in advanced NSCLC with programmed death-ligand 1 greater than or equal to 50 % and greater than or equal to 90. JTO Clin Res Rep 2023;4(12):100601. doi: 10.1016/j.jtocrr.2023.100601
  15. Ricciuti B., Elkrief A., Lin J. et al. Three-year overall survival outcomes and correlative analyses in patients with NSCLC and high (50–89 %) versus very high (≥90 %) programmed death-ligand 1 expression treated with first-line pembrolizumab or cemiplimab. JTO Clin Res Rep 2024;5(9):100675. doi: 10.1016/j.jtocrr.2024.100675

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