Five-year survival and clinical correlates among patients with advanced non-small cell lung cancer, melanoma and renal cell carcinoma treated with immune check-point inhibitors in Australian tertiary oncology centres

被引:6
作者
Brown, Lauren J. [1 ,2 ,3 ,4 ,7 ]
da Silva, Ines Pires [2 ,3 ,5 ]
Moujaber, Tania [1 ,2 ,3 ]
Gao, Bo [1 ,2 ,4 ]
Hui, Rina [1 ,3 ]
Gurney, Howard [1 ,6 ]
Carlino, Matteo [1 ,2 ,3 ,5 ]
Nagrial, Adnan [1 ,2 ,3 ]
机构
[1] Westmead Hosp, Crown Princess Mary Canc Ctr, Westmead, NSW, Australia
[2] Blacktown Hosp, Blacktown Canc & Haematol Ctr, Blacktown, NSW, Australia
[3] Univ Sydney, Camperdown, NSW, Australia
[4] Westmead Inst Med Res, Westmead, NSW, Australia
[5] Melanoma Inst Australia, Wollstonecraft, NSW, Australia
[6] Macquarie Univ, Hlth Canc Serv, Sydney, NSW, Australia
[7] Westmead Hosp, Crown Princess Mary Canc Ctr, Westmead, NSW 2145, Australia
来源
CANCER MEDICINE | 2023年 / 12卷 / 06期
关键词
immune checkpoint inhibitors; immunotherapy; melanoma; non-small cell lung cancer; renal cell carcinoma; MALIGNANT PLEURAL MESOTHELIOMA; NIVOLUMAB PLUS IPILIMUMAB; OPEN-LABEL; PEMBROLIZUMAB; MULTICENTER; METASTASIS; DOCETAXEL; CRITERIA; THERAPY; PHASE-3;
D O I
10.1002/cam4.5468
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
AimsThere is robust trial evidence for improved overall survival (OS) with immunotherapy in advanced solid organ malignancies. The real-world long-term survival data and the predictive variables are not yet known. Our aim was to evaluate factors associated with 3-year and 5-year OS for patients treated with immune checkpoint inhibitors (ICIs). MethodsWe performed a retrospective study of patients who received ICIs as management of advanced solid organ malignancies in two tertiary Australian oncology centres from 2012-2017. Data pertaining to clinical characteristics, metastatic disease burden, immune-related adverse events (IRAEs) and tumour responses were collected and their relationship to survival examined. ResultsIn this analysis of 264 patients, 202 (76.5%) had melanoma, 46 (17.4%) had non-small cell lung cancer (NSCLC), 12 (4.5%) had renal cell carcinoma (RCC) and 4 (1.5%) had mesothelioma. The 5-year OS rates were 42.1% in patients with melanoma, 19.6% with NSCLC, 75% with RCC, and none of the mesothelioma patients were alive at 5 years.In multivariate analysis, an ECOG score of 0 (Hazard ratio [HR] 0.39; 95% confidence interval [CI] 0.23-0.66; p < 0.001) and the occurrence of IRAE's of any grade (HR 0.61; 95% CI 0.37-0.95; p = 0.05) were associated with better 5-year survival. The presence of bone metastases (HR 1.62; 95% CI 1.03-2.82; p = 0.05) and liver metastases (HR 1.76; 95% CI 1.07-2.89; p = 0.03) were associated with worse 5-year survival. ConclusionsThese results support the long-term benefits of immunotherapy that in some patients, extend to at least 5 years. ECOG performance status of 0 and the occurrence of irAEs are associated with better long-term survival. Survival is significantly influenced by metastatic site and cancer type. These predictive clinical correlates aid discussions and planning in the delivery of ICIs to patients.
引用
收藏
页码:6788 / 6801
页数:14
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