Smoking status during first‐line immunotherapy and chemotherapy in NSCLC patients: A case–control matched analysis from a large multicenter study
Abstract Background Improved outcome in tobacco smoking patients with non‐small cell lung cancer (NSCLC) following immunotherapy has previously been reported. However, little is known regarding this association during first‐line immunotherapy in patients with high PD‐L1 expression. In this study we...
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| Format: | Article |
| Language: | English |
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Wiley
2021-03-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.13852 |
| _version_ | 1828925932303286272 |
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| author | Alessio Cortellini Andrea De Giglio Katia Cannita Diego L. Cortinovis Robin Cornelissen Cinzia Baldessari Raffaele Giusti Ettore D'Argento Francesco Grossi Matteo Santoni Annamaria Catino Rossana Berardi Vincenzo Sforza Giovanni Rossi Lorenzo Antonuzzo Vincenzo Di Noia Diego Signorelli Alain Gelibter Mario Alberto Occhipinti Alessandro Follador Francesca Rastelli Rita Chiari Luigi Della Gravara Alessandro Inno Michele De Tursi Pietro Di Marino Giovanni Mansueto Federica Zoratto Marco Filetti Michele Montrone Fabrizio Citarella Maria Vittoria Pensieri Marco Russano Luca Cantini Olga Nigro Alessandro Leonetti Paola Bordi Gabriele Minuti Lorenza Landi Alessandro De Toma Clelia Donisi Serena Ricciardi Maria Rita Migliorino Valerio Maria Napoli Gianmarco Leone Giulio Metro Giuseppe L. Banna Alex Friedlaender Alfredo Addeo Corrado Ficorella Giampiero Porzio |
| author_facet | Alessio Cortellini Andrea De Giglio Katia Cannita Diego L. Cortinovis Robin Cornelissen Cinzia Baldessari Raffaele Giusti Ettore D'Argento Francesco Grossi Matteo Santoni Annamaria Catino Rossana Berardi Vincenzo Sforza Giovanni Rossi Lorenzo Antonuzzo Vincenzo Di Noia Diego Signorelli Alain Gelibter Mario Alberto Occhipinti Alessandro Follador Francesca Rastelli Rita Chiari Luigi Della Gravara Alessandro Inno Michele De Tursi Pietro Di Marino Giovanni Mansueto Federica Zoratto Marco Filetti Michele Montrone Fabrizio Citarella Maria Vittoria Pensieri Marco Russano Luca Cantini Olga Nigro Alessandro Leonetti Paola Bordi Gabriele Minuti Lorenza Landi Alessandro De Toma Clelia Donisi Serena Ricciardi Maria Rita Migliorino Valerio Maria Napoli Gianmarco Leone Giulio Metro Giuseppe L. Banna Alex Friedlaender Alfredo Addeo Corrado Ficorella Giampiero Porzio |
| author_sort | Alessio Cortellini |
| collection | DOAJ |
| description | Abstract Background Improved outcome in tobacco smoking patients with non‐small cell lung cancer (NSCLC) following immunotherapy has previously been reported. However, little is known regarding this association during first‐line immunotherapy in patients with high PD‐L1 expression. In this study we compared clinical outcomes according to the smoking status of two large multicenter cohorts. Methods We compared clinical outcomes according to the smoking status (never smokers vs. current/former smokers) of two retrospective multicenter cohorts of metastatic NSCLC patients, treated with first‐line pembrolizumab and platinum‐based chemotherapy. Results A total of 962 NSCLC patients with PD‐L1 expression ≥50% who received first‐line pembrolizumab and 462 NSCLC patients who received first‐line platinum‐based chemotherapy were included in the study. Never smokers were confirmed to have a significantly higher risk of disease progression (hazard ratio [HR] = 1.49 [95% CI: 1.15–1.92], p = 0.0022) and death (HR = 1.38 [95% CI: 1.02–1.87], p = 0.0348) within the pembrolizumab cohort. On the contrary, a nonsignificant trend towards a reduced risk of disease progression (HR = 0.74 [95% CI: 0.52–1.05], p = 0.1003) and death (HR = 0.67 [95% CI: 0.45–1.01], p = 0.0593) were reported for never smokers within the chemotherapy cohort. After a random case–control matching, 424 patients from both cohorts were paired. Within the matched pembrolizumab cohort, never smokers had a significantly shorter progression‐free survival (PFS) (HR = 1.68 [95% CI: 1.17–2.40], p = 0.0045) and a nonsignificant trend towards a shortened overall survival (OS) (HR = 1.32 [95% CI: 0.84–2.07], p = 0.2205). On the contrary, never smokers had a significantly longer PFS (HR = 0.68 [95% CI: 0.49–0.95], p = 0.0255) and OS (HR = 0.66 [95% CI: 0.45–0.97], p = 0,0356) compared to current/former smoker patients within the matched chemotherapy cohort. On pooled multivariable analysis, the interaction term between smoking status and treatment modality was concordantly statistically significant with respect to ORR (p = 0.0074), PFS (p = 0.0001) and OS (p = 0.0020), confirming the significantly different impact of smoking status across the two cohorts. Conclusions Among metastatic NSCLC patients with PD‐L1 expression ≥50% receiving first‐line pembrolizumab, current/former smokers experienced improved PFS and OS. On the contrary, worse outcomes were reported among current/former smokers receiving first‐line chemotherapy. |
| first_indexed | 2024-12-13T23:23:47Z |
| format | Article |
| id | doaj.art-c7f53a01da6942bfa7ce73222085c5cd |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-12-13T23:23:47Z |
| publishDate | 2021-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-c7f53a01da6942bfa7ce73222085c5cd2022-12-21T23:27:38ZengWileyThoracic Cancer1759-77061759-77142021-03-0112688088910.1111/1759-7714.13852Smoking status during first‐line immunotherapy and chemotherapy in NSCLC patients: A case–control matched analysis from a large multicenter studyAlessio Cortellini0Andrea De Giglio1Katia Cannita2Diego L. Cortinovis3Robin Cornelissen4Cinzia Baldessari5Raffaele Giusti6Ettore D'Argento7Francesco Grossi8Matteo Santoni9Annamaria Catino10Rossana Berardi11Vincenzo Sforza12Giovanni Rossi13Lorenzo Antonuzzo14Vincenzo Di Noia15Diego Signorelli16Alain Gelibter17Mario Alberto Occhipinti18Alessandro Follador19Francesca Rastelli20Rita Chiari21Luigi Della Gravara22Alessandro Inno23Michele De Tursi24Pietro Di Marino25Giovanni Mansueto26Federica Zoratto27Marco Filetti28Michele Montrone29Fabrizio Citarella30Maria Vittoria Pensieri31Marco Russano32Luca Cantini33Olga Nigro34Alessandro Leonetti35Paola Bordi36Gabriele Minuti37Lorenza Landi38Alessandro De Toma39Clelia Donisi40Serena Ricciardi41Maria Rita Migliorino42Valerio Maria Napoli43Gianmarco Leone44Giulio Metro45Giuseppe L. Banna46Alex Friedlaender47Alfredo Addeo48Corrado Ficorella49Giampiero Porzio50Department of Surgery and Cancer Imperial College London London United KingdomDivision of Medical Oncology, S.Orsola‐Malpighi Hospital University of Bologna Bologna ItalyMedical Oncology St. Salvatore Hospital L'Aquila ItalyMedical Oncology Ospedale San Gerardo Monza ItalyDepartment of Pulmonary Diseases Erasmus Medical Center Rotterdam The NetherlandsDepartment of Oncology and Hematology Modena University Hospital Modena ItalyMedical Oncology St. Andrea Hospital Rome ItalyComprehensive Cancer Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS Rome ItalyMedical Oncology Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan ItalyMedical Oncology Hospital of Macerata Macerata ItalyThoracic Oncology Unit Clinical Cancer Center IRCCS Istituto Tumori "Giovanni Paolo II" Bari ItalyOncology Clinic Università Politecnica Delle Marche, Ospedali Riuniti Di Ancona Ancona ItalyThoracic Medical Oncology Istituto Nazionale Tumori 'Fondazione G Pascale', IRCCS Naples ItalyLung Cancer Unit IRCCS Ospedale Policlinico San Martino Genoa ItalyDepartment of Oncology Careggi University Hospital Florence ItalyUnità di Oncologia medica e Terapia Biomolecolare, Azienda Ospedaliero‐Universitaria Ospedali Riuniti di Foggia Foggia ItalyDepartment of Medical Oncology Fondazione IRCCS Istituto Nazionale dei Tumori Milan ItalyMedical Oncology (B) Policlinico Umberto I, "Sapienza" University of Rome Rome ItalyMedical Oncology (B) Policlinico Umberto I, "Sapienza" University of Rome Rome ItalyDepartment of Oncology University Hospital Santa Maria Della Misericordia Udine ItalyMedical Oncology Fermo Area Vasta 4 Fermo ItalyMedical Oncology Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta" Monselice ItalyPneumo‐Oncology Unit Monaldi Hospital Naples ItalyOncology Unit IRCCS Ospedale Sacro Cuore Don Calabria Negrar ItalyDepartment of Medical, Oral & Biotechnological Sciences University G. D'Annunzio, Chieti‐Pescara Chieti ItalyClinical Oncology Unit S.S. Annunziata Hospital Chieti ItalyMedical Oncology F. Spaziani Hospital Frosinone ItalyMedical Oncology Santa Maria Goretti Hospital Latina ItalyMedical Oncology St. Andrea Hospital Rome ItalyThoracic Oncology Unit Clinical Cancer Center IRCCS Istituto Tumori "Giovanni Paolo II" Bari ItalyMedical Oncology Campus Bio‐Medico University Rome ItalyDepartment of Surgery and Cancer Imperial College London London United KingdomMedical Oncology Campus Bio‐Medico University Rome ItalyDepartment of Pulmonary Diseases Erasmus Medical Center Rotterdam The NetherlandsMedical Oncology ASST‐Sette Laghi Varese ItalyMedical Oncology Unit University Hospital of Parma Parma ItalyMedical Oncology Unit University Hospital of Parma Parma ItalyDepartment of Oncology and Hematology AUSL Romagna Ravenna ItalyDivision of Medical Oncology, S.Orsola‐Malpighi Hospital University of Bologna Bologna ItalyDepartment of Medical Oncology Fondazione IRCCS Istituto Nazionale dei Tumori Milan ItalyMedical Oncology Unit University Hospital and University of Cagliari Cagliari ItalyPneumo‐Oncology Unit St. Camillo‐Forlanini Hospital Rome ItalyPneumo‐Oncology Unit St. Camillo‐Forlanini Hospital Rome ItalyDepartment of Oncology University of Turin, San Luigi Hospital Orbassano ItalyDepartment of Oncology University of Turin, San Luigi Hospital Orbassano ItalyDepartment of Medical Oncology Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia Perugia ItalyOncology Department Queen Alexandra University Hospital, Portsmouth Hospitals NHS Trust Portsmouth UKOncology Department University Hospital of Geneva Geneva SwitzerlandOncology Department University Hospital of Geneva Geneva SwitzerlandDepartment of Biotechnology and Applied Clinical Sciences University of L'Aquila L'Aquila ItalyMedical Oncology St. Salvatore Hospital L'Aquila ItalyAbstract Background Improved outcome in tobacco smoking patients with non‐small cell lung cancer (NSCLC) following immunotherapy has previously been reported. However, little is known regarding this association during first‐line immunotherapy in patients with high PD‐L1 expression. In this study we compared clinical outcomes according to the smoking status of two large multicenter cohorts. Methods We compared clinical outcomes according to the smoking status (never smokers vs. current/former smokers) of two retrospective multicenter cohorts of metastatic NSCLC patients, treated with first‐line pembrolizumab and platinum‐based chemotherapy. Results A total of 962 NSCLC patients with PD‐L1 expression ≥50% who received first‐line pembrolizumab and 462 NSCLC patients who received first‐line platinum‐based chemotherapy were included in the study. Never smokers were confirmed to have a significantly higher risk of disease progression (hazard ratio [HR] = 1.49 [95% CI: 1.15–1.92], p = 0.0022) and death (HR = 1.38 [95% CI: 1.02–1.87], p = 0.0348) within the pembrolizumab cohort. On the contrary, a nonsignificant trend towards a reduced risk of disease progression (HR = 0.74 [95% CI: 0.52–1.05], p = 0.1003) and death (HR = 0.67 [95% CI: 0.45–1.01], p = 0.0593) were reported for never smokers within the chemotherapy cohort. After a random case–control matching, 424 patients from both cohorts were paired. Within the matched pembrolizumab cohort, never smokers had a significantly shorter progression‐free survival (PFS) (HR = 1.68 [95% CI: 1.17–2.40], p = 0.0045) and a nonsignificant trend towards a shortened overall survival (OS) (HR = 1.32 [95% CI: 0.84–2.07], p = 0.2205). On the contrary, never smokers had a significantly longer PFS (HR = 0.68 [95% CI: 0.49–0.95], p = 0.0255) and OS (HR = 0.66 [95% CI: 0.45–0.97], p = 0,0356) compared to current/former smoker patients within the matched chemotherapy cohort. On pooled multivariable analysis, the interaction term between smoking status and treatment modality was concordantly statistically significant with respect to ORR (p = 0.0074), PFS (p = 0.0001) and OS (p = 0.0020), confirming the significantly different impact of smoking status across the two cohorts. Conclusions Among metastatic NSCLC patients with PD‐L1 expression ≥50% receiving first‐line pembrolizumab, current/former smokers experienced improved PFS and OS. On the contrary, worse outcomes were reported among current/former smokers receiving first‐line chemotherapy.https://doi.org/10.1111/1759-7714.13852immunotherapynon‐small cell lung cancerpembrolizumabsmokingtobacco |
| spellingShingle | Alessio Cortellini Andrea De Giglio Katia Cannita Diego L. Cortinovis Robin Cornelissen Cinzia Baldessari Raffaele Giusti Ettore D'Argento Francesco Grossi Matteo Santoni Annamaria Catino Rossana Berardi Vincenzo Sforza Giovanni Rossi Lorenzo Antonuzzo Vincenzo Di Noia Diego Signorelli Alain Gelibter Mario Alberto Occhipinti Alessandro Follador Francesca Rastelli Rita Chiari Luigi Della Gravara Alessandro Inno Michele De Tursi Pietro Di Marino Giovanni Mansueto Federica Zoratto Marco Filetti Michele Montrone Fabrizio Citarella Maria Vittoria Pensieri Marco Russano Luca Cantini Olga Nigro Alessandro Leonetti Paola Bordi Gabriele Minuti Lorenza Landi Alessandro De Toma Clelia Donisi Serena Ricciardi Maria Rita Migliorino Valerio Maria Napoli Gianmarco Leone Giulio Metro Giuseppe L. Banna Alex Friedlaender Alfredo Addeo Corrado Ficorella Giampiero Porzio Smoking status during first‐line immunotherapy and chemotherapy in NSCLC patients: A case–control matched analysis from a large multicenter study Thoracic Cancer immunotherapy non‐small cell lung cancer pembrolizumab smoking tobacco |
| title | Smoking status during first‐line immunotherapy and chemotherapy in NSCLC patients: A case–control matched analysis from a large multicenter study |
| title_full | Smoking status during first‐line immunotherapy and chemotherapy in NSCLC patients: A case–control matched analysis from a large multicenter study |
| title_fullStr | Smoking status during first‐line immunotherapy and chemotherapy in NSCLC patients: A case–control matched analysis from a large multicenter study |
| title_full_unstemmed | Smoking status during first‐line immunotherapy and chemotherapy in NSCLC patients: A case–control matched analysis from a large multicenter study |
| title_short | Smoking status during first‐line immunotherapy and chemotherapy in NSCLC patients: A case–control matched analysis from a large multicenter study |
| title_sort | smoking status during first line immunotherapy and chemotherapy in nsclc patients a case control matched analysis from a large multicenter study |
| topic | immunotherapy non‐small cell lung cancer pembrolizumab smoking tobacco |
| url | https://doi.org/10.1111/1759-7714.13852 |
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