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2018 ; 13
(4
): e0195945
Nephropedia Template TP
gab.com Text
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Clinical factors associated with early progression and grade 3-4 toxicity in
patients with advanced non-small-cell lung cancers treated with nivolumab
#MMPMID29684049
Dumenil C
; Massiani MA
; Dumoulin J
; Giraud V
; Labrune S
; Chinet T
; Giroux Leprieur E
PLoS One
2018[]; 13
(4
): e0195945
PMID29684049
show ga
INTRODUCTION: The prognosis of advanced non-small-cell lung cancer (NSCLC) has
been improved by development of immune checkpoint inhibitors (ICIs) such as
nivolumab for second-line treatment. As phase III trials include only selected
patients, we here investigated the clinical factors associated with efficacy and
safety of nivolumab in 'real life' patients with advanced NSCLC. METHODS:
Clinical and histological characteristics, therapies and survival data of all
consecutive patients with advanced NSCLC included prospectively and treated by
nivolumab in two French academic hospitals between February 2015 and December
2016 were examined. RESULTS: Sixty-seven patients were included, mostly male
(69%), current or former smokers (87%) with PS <2 (73%). Median age was 68.5
years and 42% were aged ?70 years. According to uni- and multi-variate analyses,
only PS 2 (OR = 0.17, 95% CI 0.03-0.99, p = 0.049) and number of previous
treatment lines (OR = 0.33, 95% CI 0.13-0.85, p = 0.022) were significantly
negatively associated with tumor control. Worse progression-free survival (PFS)
was significantly associated with PS 2 (HR = 5.17, 95% CI 1.99-13.43, p = 0.001)
and use of steroids (HR = 3.27, 95% CI 1.39-7.69, p = 0.006). Worse overall
survival was associated with symptomatic brain metastasis (HR = 3.15, 95% CI
1.23-8.85, p = 0.029). Treatment-related adverse events occurred in 47 patients
(70%), symptomatic brain metastasis being significantly associated with Grade ?3
toxicity (OR = 8.13, 95% CI 1.21-55.56, p = 0.031). Age and nutritional status
were not associated with response, PFS, OS or toxicity. CONCLUSION: Our results
suggest that nivolumab is not beneficial or safe for patients with PS 2 and
symptomatic brain metastases.