PD-1 inhibition plus platinum-based chemotherapy (PBC) or PBC alone in the first-line treatment of locally advanced or metastatic pulmonary lymphoepithelioma-like carcinoma
BackgroundPulmonary lymphoepithelioma-like carcinoma (PLELC) is a distinctive subtype of non-small cell lung carcinoma that was not well presented in clinical studies. The management of advanced PLELC remains an important, unmet need due to the paucity of high-grade evidence. Herein, we carried out...
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1015444/full |
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| author | Xuanye Zhang Xuanye Zhang Xuanye Zhang Yixin Zhou Yixin Zhou Yixin Zhou Hualin Chen Chen Chen Chen Chen Chen Chen Zuan Lin Zuan Lin Zuan Lin Li-na He Li-na He Li-na He Wei Du Wei Du Wei Du Tao Chen Tao Chen Tao Chen Shaodong Hong Shaodong Hong Shaodong Hong Sha Fu Sha Fu |
| author_facet | Xuanye Zhang Xuanye Zhang Xuanye Zhang Yixin Zhou Yixin Zhou Yixin Zhou Hualin Chen Chen Chen Chen Chen Chen Chen Zuan Lin Zuan Lin Zuan Lin Li-na He Li-na He Li-na He Wei Du Wei Du Wei Du Tao Chen Tao Chen Tao Chen Shaodong Hong Shaodong Hong Shaodong Hong Sha Fu Sha Fu |
| author_sort | Xuanye Zhang |
| collection | DOAJ |
| description | BackgroundPulmonary lymphoepithelioma-like carcinoma (PLELC) is a distinctive subtype of non-small cell lung carcinoma that was not well presented in clinical studies. The management of advanced PLELC remains an important, unmet need due to the paucity of high-grade evidence. Herein, we carried out a multicenter, retrospective study to assess the effectiveness and tolerability of PD-1/PD-L1 inhibitor plus chemotherapy versus chemotherapy alone for patients with advanced PLELC in the first-line setting.Patients and MethodsThis retrospective study enrolled patients with advanced PLELC receiving first-line treatment with PD-1 inhibition plus chemotherapy (IO-Chemo group) or chemotherapy alone (Chemo group) in three medical centers in China. The survival outcomes, efficacy, and safety profile were investigated. The primary endpoint was progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), overall survival (OS), and adverse events (AEs).ResultsA total of 133 patients were enrolled. PFS was significantly longer in the IO-Chemo group (median 12.8 months [95% CI 5.2-20.4]) than that in the Chemo group (median 7.7 months [95% CI 6.8-8.6]; hazard ratio [HR] 0.48 [95% CI 0.31-0.74]; P=0.001). ORR was 74.5% (95% CI, 63.0-86.1) in the IO-Chemo group and 34.6% (95% CI, 24.1-45.2) in the Chemo group (P<0.001). The median OS was not reached in the IO-Chemo group versus 35.7 months (95% CI 26.7-44.8) in the Chemo group (HR 0.47 [95% CI 0.20-1.07]; P=0.065). Multivariate analysis revealed that PD-1/PD-L1 inhibitor combination was independently associated with longer PFS (HR 0.40 [95% CI 0.25-0.63]; P<0.001). Grade 3 or higher AEs occurred in 36 (65.5%) patients in the IO-Chemo group and 56 (71.8%) patients in the Chemo group, respectively.ConclusionsIn patients with advanced PLELC, adding PD-1/PD-L1 inhibitor to platinum-based chemotherapy significantly increased PFS and ORR with a tolerable safety profile. |
| first_indexed | 2024-04-12T03:55:18Z |
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| language | English |
| last_indexed | 2024-04-12T03:55:18Z |
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| series | Frontiers in Immunology |
| spelling | doaj.art-ab2ad6a4ddf14278a29e41ada3a8349c2022-12-22T03:48:51ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-09-011310.3389/fimmu.2022.10154441015444PD-1 inhibition plus platinum-based chemotherapy (PBC) or PBC alone in the first-line treatment of locally advanced or metastatic pulmonary lymphoepithelioma-like carcinomaXuanye Zhang0Xuanye Zhang1Xuanye Zhang2Yixin Zhou3Yixin Zhou4Yixin Zhou5Hualin Chen6Chen Chen7Chen Chen8Chen Chen9Zuan Lin10Zuan Lin11Zuan Lin12Li-na He13Li-na He14Li-na He15Wei Du16Wei Du17Wei Du18Tao Chen19Tao Chen20Tao Chen21Shaodong Hong22Shaodong Hong23Shaodong Hong24Sha Fu25Sha Fu26State Key Laboratory of Oncology in South China, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Very Important Person (VIP) Region, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Pulmonary Oncology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, ChinaState Key Laboratory of Oncology in South China, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangzhou, ChinaCollaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Cellular and Molecular Diagnostics Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China0Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaBackgroundPulmonary lymphoepithelioma-like carcinoma (PLELC) is a distinctive subtype of non-small cell lung carcinoma that was not well presented in clinical studies. The management of advanced PLELC remains an important, unmet need due to the paucity of high-grade evidence. Herein, we carried out a multicenter, retrospective study to assess the effectiveness and tolerability of PD-1/PD-L1 inhibitor plus chemotherapy versus chemotherapy alone for patients with advanced PLELC in the first-line setting.Patients and MethodsThis retrospective study enrolled patients with advanced PLELC receiving first-line treatment with PD-1 inhibition plus chemotherapy (IO-Chemo group) or chemotherapy alone (Chemo group) in three medical centers in China. The survival outcomes, efficacy, and safety profile were investigated. The primary endpoint was progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), overall survival (OS), and adverse events (AEs).ResultsA total of 133 patients were enrolled. PFS was significantly longer in the IO-Chemo group (median 12.8 months [95% CI 5.2-20.4]) than that in the Chemo group (median 7.7 months [95% CI 6.8-8.6]; hazard ratio [HR] 0.48 [95% CI 0.31-0.74]; P=0.001). ORR was 74.5% (95% CI, 63.0-86.1) in the IO-Chemo group and 34.6% (95% CI, 24.1-45.2) in the Chemo group (P<0.001). The median OS was not reached in the IO-Chemo group versus 35.7 months (95% CI 26.7-44.8) in the Chemo group (HR 0.47 [95% CI 0.20-1.07]; P=0.065). Multivariate analysis revealed that PD-1/PD-L1 inhibitor combination was independently associated with longer PFS (HR 0.40 [95% CI 0.25-0.63]; P<0.001). Grade 3 or higher AEs occurred in 36 (65.5%) patients in the IO-Chemo group and 56 (71.8%) patients in the Chemo group, respectively.ConclusionsIn patients with advanced PLELC, adding PD-1/PD-L1 inhibitor to platinum-based chemotherapy significantly increased PFS and ORR with a tolerable safety profile.https://www.frontiersin.org/articles/10.3389/fimmu.2022.1015444/fullpulmonary lymphoepithelioma-like carcinomaPD-1PD-L1immunotherapychemotherapy |
| spellingShingle | Xuanye Zhang Xuanye Zhang Xuanye Zhang Yixin Zhou Yixin Zhou Yixin Zhou Hualin Chen Chen Chen Chen Chen Chen Chen Zuan Lin Zuan Lin Zuan Lin Li-na He Li-na He Li-na He Wei Du Wei Du Wei Du Tao Chen Tao Chen Tao Chen Shaodong Hong Shaodong Hong Shaodong Hong Sha Fu Sha Fu PD-1 inhibition plus platinum-based chemotherapy (PBC) or PBC alone in the first-line treatment of locally advanced or metastatic pulmonary lymphoepithelioma-like carcinoma Frontiers in Immunology pulmonary lymphoepithelioma-like carcinoma PD-1 PD-L1 immunotherapy chemotherapy |
| title | PD-1 inhibition plus platinum-based chemotherapy (PBC) or PBC alone in the first-line treatment of locally advanced or metastatic pulmonary lymphoepithelioma-like carcinoma |
| title_full | PD-1 inhibition plus platinum-based chemotherapy (PBC) or PBC alone in the first-line treatment of locally advanced or metastatic pulmonary lymphoepithelioma-like carcinoma |
| title_fullStr | PD-1 inhibition plus platinum-based chemotherapy (PBC) or PBC alone in the first-line treatment of locally advanced or metastatic pulmonary lymphoepithelioma-like carcinoma |
| title_full_unstemmed | PD-1 inhibition plus platinum-based chemotherapy (PBC) or PBC alone in the first-line treatment of locally advanced or metastatic pulmonary lymphoepithelioma-like carcinoma |
| title_short | PD-1 inhibition plus platinum-based chemotherapy (PBC) or PBC alone in the first-line treatment of locally advanced or metastatic pulmonary lymphoepithelioma-like carcinoma |
| title_sort | pd 1 inhibition plus platinum based chemotherapy pbc or pbc alone in the first line treatment of locally advanced or metastatic pulmonary lymphoepithelioma like carcinoma |
| topic | pulmonary lymphoepithelioma-like carcinoma PD-1 PD-L1 immunotherapy chemotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1015444/full |
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