Efficacy and Safety of PD-1 Inhibitors Monotherapy for Elderly Patients with Advanced Non-small Cell Lung Cancer
Background Immunotherapy represented by programmed death protein-1 (PD-1) inhibitors has gradually become the standard treatment of advanced non-small cell lung cancer (NSCLC) in recent years, changing the treatment landscape of advanced NSCLC. However, most PD-1-related studies excluded patients wi...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | zho |
| Published: |
Chinese General Practice Publishing House Co., Ltd
2023-01-01
|
| Series: | Zhongguo quanke yixue |
| Subjects: | |
| Online Access: | https://www.chinagp.net/fileup/1007-9572/PDF/zx20220567.pdf |
| _version_ | 1797216814879473664 |
|---|---|
| author | SONG Pingan, CHEN Xiaoliang, YAO Yuan, GAO Jin, YANG Yang, CUI Hongchun, ZHANG Yi |
| author_facet | SONG Pingan, CHEN Xiaoliang, YAO Yuan, GAO Jin, YANG Yang, CUI Hongchun, ZHANG Yi |
| author_sort | SONG Pingan, CHEN Xiaoliang, YAO Yuan, GAO Jin, YANG Yang, CUI Hongchun, ZHANG Yi |
| collection | DOAJ |
| description | Background Immunotherapy represented by programmed death protein-1 (PD-1) inhibitors has gradually become the standard treatment of advanced non-small cell lung cancer (NSCLC) in recent years, changing the treatment landscape of advanced NSCLC. However, most PD-1-related studies excluded patients with NSCLC more than 70 or 75 years, resulting in relatively limited data about the efficacy and safety of PD-1 inhibitors in elderly patients. Objective This study aims to evaluate the efficacy and safety of PD-1 inhibitors in elderly patients with advanced NSCCL. Methods This study selected elderly patients with advanced NSCLC over 65 years who received PD-1 inhibitors monotherapy in Department of Thoracic Surgery and Oncology of the Fourth Affiliated Hospital of Gansu University of Traditional Chinese Medicine from October 2018 to November 2021. A total of 63 elderly patients with NSCLC were included. The PD-1 inhibitors of the study were approved in Chinese market, including camrelizumab, sintilimab and pembrolizumab. The data about efficacy and safety of PD-1 inhibitors were collected in the hospital electronic medical record system. All patients were followed up regularly to obtain the long-term prognostic data until 2022-03-15. The efficacy data of PD-1 inhibitors, the prognosis of elderly patients with advanced NSCLC and the toxicity and side effects of PD-1 inhibitors were collected. Cox comparative risk model was used to explore the influencing factors of the prognosis of elderly patients with advanced NSCLC. Results The median age of the 63 elderly patients with advanced NSCLC was 71 (65, 89) years. The best response assessment during PD-1 inhibitors therapy showed that no patients had complete response, 14 patients had partial responses, 21 patients had stable status, and 28 patients had progressive status. The objective response rate (ORR) of patients with advanced NSCLC treated with PD-1 inhibitors monotherapy was 22.2% (14/63) , and the disease control rate (DCR) was 66.7% (14/21) . Prognostic data showed that the median progression free survival (PFS) of the 63 patients with advanced NSCLC was 3.3 (2.0, 4.6) months and the median overall survival (OS) was 10.2 (6.1, 14.3) months. Among 63 elderly patients with NSCLC, 46 of them (73.0%) had treatment related adverse reaction during PD-1 inhibitors monotherapy, and the rate of grade 3 or above adverse reactions was 14.3%. The most common adverse reactions were fatigue, diarrhea, rash and abnormal liver function with the rates of 23.8% (15/63) , 19.1% (12/63) , 15.9% (10/63) and 14.3% (9/63) , respectively. Cox comparative risk model analysis suggested that ECOG performance status and number of metastatic lesions might be independent factors of PFS in patients with advanced NSCLC treated with PD-1 inhibittors. Conclusion PD-1 blockades monotherapy demonstrated potential efficacy and acceptable safety for elderly patients with NSCLC. ECOG performance status and number of metastatic lesions might be potential risk factors that predict the PFS of the patients. |
| first_indexed | 2024-04-24T11:51:57Z |
| format | Article |
| id | doaj.art-19f0259d51174a34a25d5897ca6fcb42 |
| institution | Directory Open Access Journal |
| issn | 1007-9572 |
| language | zho |
| last_indexed | 2024-04-24T11:51:57Z |
| publishDate | 2023-01-01 |
| publisher | Chinese General Practice Publishing House Co., Ltd |
| record_format | Article |
| series | Zhongguo quanke yixue |
| spelling | doaj.art-19f0259d51174a34a25d5897ca6fcb422024-04-09T06:51:05ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722023-01-01260224124710.12114/j.issn.1007-9572.2022.0567Efficacy and Safety of PD-1 Inhibitors Monotherapy for Elderly Patients with Advanced Non-small Cell Lung CancerSONG Pingan, CHEN Xiaoliang, YAO Yuan, GAO Jin, YANG Yang, CUI Hongchun, ZHANG Yi01Department of Thoracic Surgery, the Fourth Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Lanzhou 730099, China;2Gansu University of Traditional Chinese Medicine, Lanzhou 730000, ChinaBackground Immunotherapy represented by programmed death protein-1 (PD-1) inhibitors has gradually become the standard treatment of advanced non-small cell lung cancer (NSCLC) in recent years, changing the treatment landscape of advanced NSCLC. However, most PD-1-related studies excluded patients with NSCLC more than 70 or 75 years, resulting in relatively limited data about the efficacy and safety of PD-1 inhibitors in elderly patients. Objective This study aims to evaluate the efficacy and safety of PD-1 inhibitors in elderly patients with advanced NSCCL. Methods This study selected elderly patients with advanced NSCLC over 65 years who received PD-1 inhibitors monotherapy in Department of Thoracic Surgery and Oncology of the Fourth Affiliated Hospital of Gansu University of Traditional Chinese Medicine from October 2018 to November 2021. A total of 63 elderly patients with NSCLC were included. The PD-1 inhibitors of the study were approved in Chinese market, including camrelizumab, sintilimab and pembrolizumab. The data about efficacy and safety of PD-1 inhibitors were collected in the hospital electronic medical record system. All patients were followed up regularly to obtain the long-term prognostic data until 2022-03-15. The efficacy data of PD-1 inhibitors, the prognosis of elderly patients with advanced NSCLC and the toxicity and side effects of PD-1 inhibitors were collected. Cox comparative risk model was used to explore the influencing factors of the prognosis of elderly patients with advanced NSCLC. Results The median age of the 63 elderly patients with advanced NSCLC was 71 (65, 89) years. The best response assessment during PD-1 inhibitors therapy showed that no patients had complete response, 14 patients had partial responses, 21 patients had stable status, and 28 patients had progressive status. The objective response rate (ORR) of patients with advanced NSCLC treated with PD-1 inhibitors monotherapy was 22.2% (14/63) , and the disease control rate (DCR) was 66.7% (14/21) . Prognostic data showed that the median progression free survival (PFS) of the 63 patients with advanced NSCLC was 3.3 (2.0, 4.6) months and the median overall survival (OS) was 10.2 (6.1, 14.3) months. Among 63 elderly patients with NSCLC, 46 of them (73.0%) had treatment related adverse reaction during PD-1 inhibitors monotherapy, and the rate of grade 3 or above adverse reactions was 14.3%. The most common adverse reactions were fatigue, diarrhea, rash and abnormal liver function with the rates of 23.8% (15/63) , 19.1% (12/63) , 15.9% (10/63) and 14.3% (9/63) , respectively. Cox comparative risk model analysis suggested that ECOG performance status and number of metastatic lesions might be independent factors of PFS in patients with advanced NSCLC treated with PD-1 inhibittors. Conclusion PD-1 blockades monotherapy demonstrated potential efficacy and acceptable safety for elderly patients with NSCLC. ECOG performance status and number of metastatic lesions might be potential risk factors that predict the PFS of the patients.https://www.chinagp.net/fileup/1007-9572/PDF/zx20220567.pdfaged|carcinoma, non-small-cell lung|immune checkpoint inhibitors|programmed cell death 1 receptor blockades|drug therapy|treatment outcome|safety |
| spellingShingle | SONG Pingan, CHEN Xiaoliang, YAO Yuan, GAO Jin, YANG Yang, CUI Hongchun, ZHANG Yi Efficacy and Safety of PD-1 Inhibitors Monotherapy for Elderly Patients with Advanced Non-small Cell Lung Cancer Zhongguo quanke yixue aged|carcinoma, non-small-cell lung|immune checkpoint inhibitors|programmed cell death 1 receptor blockades|drug therapy|treatment outcome|safety |
| title | Efficacy and Safety of PD-1 Inhibitors Monotherapy for Elderly Patients with Advanced Non-small Cell Lung Cancer |
| title_full | Efficacy and Safety of PD-1 Inhibitors Monotherapy for Elderly Patients with Advanced Non-small Cell Lung Cancer |
| title_fullStr | Efficacy and Safety of PD-1 Inhibitors Monotherapy for Elderly Patients with Advanced Non-small Cell Lung Cancer |
| title_full_unstemmed | Efficacy and Safety of PD-1 Inhibitors Monotherapy for Elderly Patients with Advanced Non-small Cell Lung Cancer |
| title_short | Efficacy and Safety of PD-1 Inhibitors Monotherapy for Elderly Patients with Advanced Non-small Cell Lung Cancer |
| title_sort | efficacy and safety of pd 1 inhibitors monotherapy for elderly patients with advanced non small cell lung cancer |
| topic | aged|carcinoma, non-small-cell lung|immune checkpoint inhibitors|programmed cell death 1 receptor blockades|drug therapy|treatment outcome|safety |
| url | https://www.chinagp.net/fileup/1007-9572/PDF/zx20220567.pdf |
| work_keys_str_mv | AT songpinganchenxiaoliangyaoyuangaojinyangyangcuihongchunzhangyi efficacyandsafetyofpd1inhibitorsmonotherapyforelderlypatientswithadvancednonsmallcelllungcancer |