Concurrent sintilimab with sequential chemoradiotherapy for unresectable, stage III non-small cell lung cancer: a retrospective study

BackgroundConcurrent programmed death 1 (PD-1) or programmed death ligand 1 (PD-L1) inhibitors with sequential chemoradiotherapy (SCRT) have been reported in only a limited number of studies involving patients with unresectable stage III non-small-cell lung cancer (NSCLC). A retrospective study was...

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Main Authors: Shi Tang, Xiaofeng Cong, Dan Zheng, Chen Chen, Zengguang Liu, Jie Gao, Huimin Zhang, Youhao Zhang, Ziling Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-04-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2023.1129989/full
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author Shi Tang
Xiaofeng Cong
Dan Zheng
Chen Chen
Zengguang Liu
Jie Gao
Huimin Zhang
Youhao Zhang
Ziling Liu
author_facet Shi Tang
Xiaofeng Cong
Dan Zheng
Chen Chen
Zengguang Liu
Jie Gao
Huimin Zhang
Youhao Zhang
Ziling Liu
author_sort Shi Tang
collection DOAJ
description BackgroundConcurrent programmed death 1 (PD-1) or programmed death ligand 1 (PD-L1) inhibitors with sequential chemoradiotherapy (SCRT) have been reported in only a limited number of studies involving patients with unresectable stage III non-small-cell lung cancer (NSCLC). A retrospective study was conducted to systematically analyze the efficacy and safety of the emerging therapy among Chinese patients.Materials and methodsWe included patients with unresectable, stage III NSCLC who received concurrent sintilimab with chemotherapy or chemotherapy alone for 3-6 cycles, followed by radical radiotherapy at the First Hospital of Jilin University from Dec 15, 2019, to Jul 15, 2022. The primary end point was the objective response rate (ORR). The secondary end points included progression-free survival (PFS), overall survival (OS), 12-month and 18-month PFS rates, the duration of response (DoR), and safety.ResultsThe retrospective study involved 77 patients, of which 49 receiving concurrent sintilimab with SCRT were assigned to cohort A, and 28 receiving SCRT alone were assigned to cohort B. The ORR was significantly higher in cohort A (79.6%, 95% CI 65.7–89.8) than in cohort B (35.7%, 95% CI 18.6–55.9) (p<0.001). Median PFS was significantly longer in cohort A than in cohort B (NR [95% CI 21.4–NR] vs. 16.0 months [13.0–22.5]; HR 0.375, 95% CI 0.192–0.735; p=0.003). The PFS rates at 12 and 18 months were 84.8% (95% CI 75.0–95.9) and 71.3% (95% CI 58.7–86.7) in cohort A and 75.0% (95% CI 60.6–92.9) and 38.3% (95% CI 23.7–61.7) in cohort B, respectively. Grade 3 or 4 adverse events (AEs) were reported in 19 patients (38.8%) and seven patients (25.0%) in two cohorts, respectively. Grade 3 or 4 pneumonitis or immune-mediated pneumonitis, radiation pneumonitis, and pneumonia occurred in five (10.2%), four (8.2%), and two (4.1%) cohort A patients, and zero, two (7.1%), and two (7.1%) cohort B patients, respectively. Only cohort A reported AE leading to death in one (2.0%) patient (immune-mediated pneumonitis).ConclusionConcurrent sintilimab with SCRT resulted in a significantly better ORR and longer PFS than SCRT alone, with manageable safety profiles in Chinese patients with unresectable stage III NSCLC.
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spelling doaj.art-da52755276d145d18c4d189419afe3742023-04-20T06:00:15ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-04-011310.3389/fonc.2023.11299891129989Concurrent sintilimab with sequential chemoradiotherapy for unresectable, stage III non-small cell lung cancer: a retrospective studyShi TangXiaofeng CongDan ZhengChen ChenZengguang LiuJie GaoHuimin ZhangYouhao ZhangZiling LiuBackgroundConcurrent programmed death 1 (PD-1) or programmed death ligand 1 (PD-L1) inhibitors with sequential chemoradiotherapy (SCRT) have been reported in only a limited number of studies involving patients with unresectable stage III non-small-cell lung cancer (NSCLC). A retrospective study was conducted to systematically analyze the efficacy and safety of the emerging therapy among Chinese patients.Materials and methodsWe included patients with unresectable, stage III NSCLC who received concurrent sintilimab with chemotherapy or chemotherapy alone for 3-6 cycles, followed by radical radiotherapy at the First Hospital of Jilin University from Dec 15, 2019, to Jul 15, 2022. The primary end point was the objective response rate (ORR). The secondary end points included progression-free survival (PFS), overall survival (OS), 12-month and 18-month PFS rates, the duration of response (DoR), and safety.ResultsThe retrospective study involved 77 patients, of which 49 receiving concurrent sintilimab with SCRT were assigned to cohort A, and 28 receiving SCRT alone were assigned to cohort B. The ORR was significantly higher in cohort A (79.6%, 95% CI 65.7–89.8) than in cohort B (35.7%, 95% CI 18.6–55.9) (p<0.001). Median PFS was significantly longer in cohort A than in cohort B (NR [95% CI 21.4–NR] vs. 16.0 months [13.0–22.5]; HR 0.375, 95% CI 0.192–0.735; p=0.003). The PFS rates at 12 and 18 months were 84.8% (95% CI 75.0–95.9) and 71.3% (95% CI 58.7–86.7) in cohort A and 75.0% (95% CI 60.6–92.9) and 38.3% (95% CI 23.7–61.7) in cohort B, respectively. Grade 3 or 4 adverse events (AEs) were reported in 19 patients (38.8%) and seven patients (25.0%) in two cohorts, respectively. Grade 3 or 4 pneumonitis or immune-mediated pneumonitis, radiation pneumonitis, and pneumonia occurred in five (10.2%), four (8.2%), and two (4.1%) cohort A patients, and zero, two (7.1%), and two (7.1%) cohort B patients, respectively. Only cohort A reported AE leading to death in one (2.0%) patient (immune-mediated pneumonitis).ConclusionConcurrent sintilimab with SCRT resulted in a significantly better ORR and longer PFS than SCRT alone, with manageable safety profiles in Chinese patients with unresectable stage III NSCLC.https://www.frontiersin.org/articles/10.3389/fonc.2023.1129989/fullnon-small cell lung cancerchemoradiotherapyPD1/PDL1 inhibitorsintilimabsafetyretrospective study
spellingShingle Shi Tang
Xiaofeng Cong
Dan Zheng
Chen Chen
Zengguang Liu
Jie Gao
Huimin Zhang
Youhao Zhang
Ziling Liu
Concurrent sintilimab with sequential chemoradiotherapy for unresectable, stage III non-small cell lung cancer: a retrospective study
Frontiers in Oncology
non-small cell lung cancer
chemoradiotherapy
PD1/PDL1 inhibitor
sintilimab
safety
retrospective study
title Concurrent sintilimab with sequential chemoradiotherapy for unresectable, stage III non-small cell lung cancer: a retrospective study
title_full Concurrent sintilimab with sequential chemoradiotherapy for unresectable, stage III non-small cell lung cancer: a retrospective study
title_fullStr Concurrent sintilimab with sequential chemoradiotherapy for unresectable, stage III non-small cell lung cancer: a retrospective study
title_full_unstemmed Concurrent sintilimab with sequential chemoradiotherapy for unresectable, stage III non-small cell lung cancer: a retrospective study
title_short Concurrent sintilimab with sequential chemoradiotherapy for unresectable, stage III non-small cell lung cancer: a retrospective study
title_sort concurrent sintilimab with sequential chemoradiotherapy for unresectable stage iii non small cell lung cancer a retrospective study
topic non-small cell lung cancer
chemoradiotherapy
PD1/PDL1 inhibitor
sintilimab
safety
retrospective study
url https://www.frontiersin.org/articles/10.3389/fonc.2023.1129989/full
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