Does Very Poor Performance Status Systematically Preclude Single Agent Anti-PD-1 Immunotherapy? A Multicenter Study of 35 Consecutive Patients
Anti-PD-1 antibodies prolong survival of performance status (PS) 0–1 advanced non-small-cell lung cancer (aNSCLC) patients. Their efficacy in PS 3–4 patients is unknown. Conse- cutive PS 3–4 aNSCLC patients receiving compassionate nivolumab were accrued by 12 French thoracic oncology departments, ov...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/5/1040 |
| _version_ | 1797416325453185024 |
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| author | Valérie Gounant Michael Duruisseaux Ghassen Soussi Sylvie Van Hulst Olivier Bylicki Jacques Cadranel Marie Wislez Jean Trédaniel Jean-Philippe Spano Carole Helissey Christos Chouaid Olivier Molinier Xavier Dhalluin Ludovic Doucet José Hureaux Aurélie Cazes Gérard Zalcman |
| author_facet | Valérie Gounant Michael Duruisseaux Ghassen Soussi Sylvie Van Hulst Olivier Bylicki Jacques Cadranel Marie Wislez Jean Trédaniel Jean-Philippe Spano Carole Helissey Christos Chouaid Olivier Molinier Xavier Dhalluin Ludovic Doucet José Hureaux Aurélie Cazes Gérard Zalcman |
| author_sort | Valérie Gounant |
| collection | DOAJ |
| description | Anti-PD-1 antibodies prolong survival of performance status (PS) 0–1 advanced non-small-cell lung cancer (aNSCLC) patients. Their efficacy in PS 3–4 patients is unknown. Conse- cutive PS 3–4 aNSCLC patients receiving compassionate nivolumab were accrued by 12 French thoracic oncology departments, over 24 months. Overall survival (OS) was calculated using the Kaplan-Meier method. Prognostic variables were assessed using Cox proportional hazards models. Overall, 35 PS 3–4 aNSCLC patients (median age 65 years) received a median of 4 nivolumab infusions (interquartile range [IQR], 1–7) as first- (<i>n</i> = 6) or second-line (<i>n</i> = 29) therapy. At a median of 52-month follow-up (95%CI, 41–63), 32 (91%) patients had died. Median progression-free survival was 2.1 months (95%CI, 1.1–3.2). Median OS was 4.4 months (95%CI, 0.5–8.2). Overall, 20% of patients were alive at 1 year, and 14% at 2 years. Treatment-related adverse events occurred in 8/35 patients (23%), mostly of low-grade. After adjustment, brain metastases (HR = 5.2; 95%CI, 9–14.3, <i>p</i> = 0.001) and <20 pack-years (HR = 4.8; 95%CI, 1.7–13.8, <i>p</i> = 0.003) predicted worse survival. PS improvement from 3–4 to 0–1 (<i>n</i> = 9) led to a median 43-month (95%CI, 0–102) OS. Certain patients with very poor general condition could derive long-term benefit from nivolumab salvage therapy. |
| first_indexed | 2024-03-09T06:01:42Z |
| format | Article |
| id | doaj.art-d4b3c6fc141b46a99ed3d4360ac46b7f |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T06:01:42Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-d4b3c6fc141b46a99ed3d4360ac46b7f2023-12-03T12:08:47ZengMDPI AGCancers2072-66942021-03-01135104010.3390/cancers13051040Does Very Poor Performance Status Systematically Preclude Single Agent Anti-PD-1 Immunotherapy? A Multicenter Study of 35 Consecutive PatientsValérie Gounant0Michael Duruisseaux1Ghassen Soussi2Sylvie Van Hulst3Olivier Bylicki4Jacques Cadranel5Marie Wislez6Jean Trédaniel7Jean-Philippe Spano8Carole Helissey9Christos Chouaid10Olivier Molinier11Xavier Dhalluin12Ludovic Doucet13José Hureaux14Aurélie Cazes15Gérard Zalcman16Department of Thoracic Oncology, Bichat Claude Bernard Hospital, APHP, CIC Inserm 1425, Université de Paris, 75018 Paris, FranceRespiratory Department, Louis Pradel Hospital, Hospices Civils de Lyon, 69002 Lyon, FranceDepartment of Thoracic Oncology, Bichat Claude Bernard Hospital, APHP, CIC Inserm 1425, Université de Paris, 75018 Paris, FranceDepartment of Pneumology, University Hospital of Nîmes, 30900 Nîmes, FranceRespiratory Disease Unit, Hôpital d’Instruction des Armées Sainte-Anne, 83800 Toulon, FranceDepartment of Pneumology and Thoracic Oncology, Tenon Hospital, APHP, GRC Theranoscan and Curamus Sorbonne Université, 75020 Paris, FranceCentre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, INSERM, TeamInflammation, Complement, and Cancer, 75006 Paris, FranceGroupe Hospitalier Paris Saint-Joseph, Department of Pneumology, Université de Paris, Sorbonne Paris Cité, Unité INSERM UMR-S 1124, 75014 Paris, FranceDepartment of Medical Oncology, Pitié-Salpétrière Hospital, APHP, Sorbonne Université, 75013 Paris, FranceClinical Research Unit, Hôpital d’Instruction des Armées Bégin, 94160 Saint-Mandé, FranceDepartment of Pneumology, Centre Hospitalier Intercommunal de Créteil, University Paris–Est Créteil (UPEC), CEpiA (Clinical Epidemiology and Ageing), EA 7376-IMRB, 94000 Créteil, FranceDepartment of Pneumology, Centre Hospitalier Le Mans, 72037 Le Mans, FranceDepartment of Pneumology and Thoracic Oncology, Calmette Hospital, Centre Hospitalier Universitaire de Lille, 59000 Lille, FranceDepartment of Oncology, Saint Louis Hospital, APHP, 75010 Paris, FranceDepartment of Pneumology, Pόle Hippocrate, University Hospital of Angers, 49100 Angers, FranceDepartment of Pathology, Bichat Claude Bernard Hospital, APHP, Université de Paris, 75018 Paris, FranceDepartment of Thoracic Oncology, Bichat Claude Bernard Hospital, APHP, CIC Inserm 1425, Université de Paris, 75018 Paris, FranceAnti-PD-1 antibodies prolong survival of performance status (PS) 0–1 advanced non-small-cell lung cancer (aNSCLC) patients. Their efficacy in PS 3–4 patients is unknown. Conse- cutive PS 3–4 aNSCLC patients receiving compassionate nivolumab were accrued by 12 French thoracic oncology departments, over 24 months. Overall survival (OS) was calculated using the Kaplan-Meier method. Prognostic variables were assessed using Cox proportional hazards models. Overall, 35 PS 3–4 aNSCLC patients (median age 65 years) received a median of 4 nivolumab infusions (interquartile range [IQR], 1–7) as first- (<i>n</i> = 6) or second-line (<i>n</i> = 29) therapy. At a median of 52-month follow-up (95%CI, 41–63), 32 (91%) patients had died. Median progression-free survival was 2.1 months (95%CI, 1.1–3.2). Median OS was 4.4 months (95%CI, 0.5–8.2). Overall, 20% of patients were alive at 1 year, and 14% at 2 years. Treatment-related adverse events occurred in 8/35 patients (23%), mostly of low-grade. After adjustment, brain metastases (HR = 5.2; 95%CI, 9–14.3, <i>p</i> = 0.001) and <20 pack-years (HR = 4.8; 95%CI, 1.7–13.8, <i>p</i> = 0.003) predicted worse survival. PS improvement from 3–4 to 0–1 (<i>n</i> = 9) led to a median 43-month (95%CI, 0–102) OS. Certain patients with very poor general condition could derive long-term benefit from nivolumab salvage therapy.https://www.mdpi.com/2072-6694/13/5/1040non-small cell lung cancerpoor performance statusimmunotherapynivolumabbrain metastases |
| spellingShingle | Valérie Gounant Michael Duruisseaux Ghassen Soussi Sylvie Van Hulst Olivier Bylicki Jacques Cadranel Marie Wislez Jean Trédaniel Jean-Philippe Spano Carole Helissey Christos Chouaid Olivier Molinier Xavier Dhalluin Ludovic Doucet José Hureaux Aurélie Cazes Gérard Zalcman Does Very Poor Performance Status Systematically Preclude Single Agent Anti-PD-1 Immunotherapy? A Multicenter Study of 35 Consecutive Patients Cancers non-small cell lung cancer poor performance status immunotherapy nivolumab brain metastases |
| title | Does Very Poor Performance Status Systematically Preclude Single Agent Anti-PD-1 Immunotherapy? A Multicenter Study of 35 Consecutive Patients |
| title_full | Does Very Poor Performance Status Systematically Preclude Single Agent Anti-PD-1 Immunotherapy? A Multicenter Study of 35 Consecutive Patients |
| title_fullStr | Does Very Poor Performance Status Systematically Preclude Single Agent Anti-PD-1 Immunotherapy? A Multicenter Study of 35 Consecutive Patients |
| title_full_unstemmed | Does Very Poor Performance Status Systematically Preclude Single Agent Anti-PD-1 Immunotherapy? A Multicenter Study of 35 Consecutive Patients |
| title_short | Does Very Poor Performance Status Systematically Preclude Single Agent Anti-PD-1 Immunotherapy? A Multicenter Study of 35 Consecutive Patients |
| title_sort | does very poor performance status systematically preclude single agent anti pd 1 immunotherapy a multicenter study of 35 consecutive patients |
| topic | non-small cell lung cancer poor performance status immunotherapy nivolumab brain metastases |
| url | https://www.mdpi.com/2072-6694/13/5/1040 |
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