Immune checkpoint inhibitor therapy for advanced cutaneous squamous cell carcinoma in Australia: a retrospective real world cohort study

被引：10

作者：

McLean, Luke S. ^{[1
,2
]}

Lim, Annette M. ^{[1
,2
]}

Bressel, Mathias ^{[2
,3
]}

Lee, Jenny ^{[4
,5
]}

Ladwa, Rahul ^{[6
,7
]}

Guminski, Alexander D. ^{[8
]}

Hughes, Brett ^{[7
,9
]}

Bowyer, Samantha ^{[10
]}

Briscoe, Karen ^{[11
]}

Harris, Samuel ^{[12
]}

Kukard, Craig ^{[13
]}

Zielinski, Rob ^{[14
,15
]}

Alamgeer, Muhammad ^{[16
,17
]}

Carlino, Matteo ^{[18
,19
,20
]}

Mo, Jeremy ^{[21
]}

Park, John J. ^{[22
]}

Khattak, Muhammad A. ^{[23
,24
]}

Day, Fiona ^{[25
]}

Rischin, Danny ^{[1
,2
]}

机构：

[1] Peter MacCallum Canc Ctr, Parkville, Vic, Australia

[2] Univ Melbourne, Parkville, Vic, Australia

[3] Peter MacCallum Canc Ctr, Ctr Biostat & Clin Trials, Melbourne, Vic, Australia

[4] Chris OBrien Lifehouse, Sydney, NSW, Australia

[5] Macquarie Univ, Sydney, NSW, Australia

[6] Princess Alexandra Hosp, Brisbane, Qld, Australia

[7] Univ Queensland, Brisbane, Qld, Australia

[8] Royal North Shore Hosp, Northern Sydney Canc Ctr, Sydney, NSW, Australia

[9] Royal Brisbane & Womens Hosp, Brisbane, Qld, Australia

[10] Sir Charles Gairdner Hosp, Perth, WA, Australia

[11] Mid North Coast Canc Inst, Coffs Harbour, NSW, Australia

[12] Bendigo Hlth, Bendigo Canc Ctr, Bendigo, Vic, Australia

[13] Cent Coast Canc Ctr, Gosford, NSW, Australia

[14] Cent West Canc Care Ctr, Orange, NSW, Australia

[15] Western Sydney Univ, Penrith, NSW, Australia

[16] Monash Hlth, Melbourne, Vic, Australia

[17] Monash Univ, Melbourne, Vic, Australia

[18] Westmead Hosp, Melanoma Inst Australia, Sydney, NSW, Australia

[19] Blacktown Hosp, Melanoma Inst Australia, Sydney, NSW, Australia

[20] Univ Sydney, Sydney, NSW, Australia

[21] Westmead Hosp, Sydney, NSW, Australia

[22] Nepean Canc Care Ctr, Penrith, NSW, Australia

[23] Fiona Stanley Hosp, Perth, WA, Australia

[24] Edith Cowan Univ, Perth, WA, Australia

[25] Calvary Mater, Newcastle, NSW, Australia

来源：

MEDICAL JOURNAL OF AUSTRALIA | 2024年 / 220卷 / 02期

基金：

英国医学研究理事会;

关键词：

Skin neoplasms; Immunotherapies; Comorbidities; Cancer; Immunosuppression; SINGLE-ARM; CEMIPLIMAB; CRITERIA; RECIST;

D O I：

10.5694/mja2.52199

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

ObjectivesTo review the outcomes of immune checkpoint inhibitor (ICI) treatment of advanced cutaneous squamous cell carcinoma (CSCC) outside clinical trials.Study designRetrospective observational study; review of patient records in fifteen Australian institutions.Setting, participantsAll Australian adults with locally advanced or metastatic CSCC not amenable to curative surgery or radiotherapy treated with ICIs, 5 May 2017 - 23 May 2022, through a cemiplimab compassionate access scheme (Therapeutic Goods Administration Special Access Scheme) or who personally covered the cost of pembrolizumab prior to the start of the access scheme.Main outcome measuresBest overall response rate (ORR) according to standardised assessment criteria using the hierarchy: Response Evaluation Criteria in Solid Tumors (RECIST 1.1), the modified World Health Organization clinical response criteria, and the Positron Emission Tomography Response Criteria (PERCIST 1.0); overall and progression-free survival.ResultsA total of 286 people with advanced CSCC received ICI therapy during May 2017 - May 2022 (cemiplimab, 270; pembrolizumab, 16). Their median age was 75.2 years (range, 39.3-97.5 years) and 232 were men (81%); median follow-up time was 12.2 months (interquartile range, 5.5-20.5 months). Eighty-eight people (31%) were immunocompromised, 27 had autoimmune disease, and 59 of 277 (21%) had ECOG performance scores of 2 or 3. The ORR was 60% (166 of 278 evaluable patients): complete responses were recorded for 74 (27%) and partial responses for 92 patients (33%). Twelve-month overall survival was 78% (95% confidence interval [CI], 72-83%); progression-free survival was 65% (95% CI, 58-70%). Poorer ECOG performance status was associated with poorer overall survival (per unit: adjusted hazard ratio [aHR], 3.0; 95% CI, 2.0-4.3) and progression-free survival (aHR, 2.4; 95% CI, 1.8-3.3), as was being immunocompromised (overall: aHR, 1.8; 95% CI, 1.1-3.0; progression-free: aHR, 1.8; 95% CI, 1.2-2.7). Fifty-five people (19%) reported immune-related adverse events of grade 2 or higher; there were no treatment-related deaths.ConclusionIn our retrospective study, the effectiveness and toxicity of ICI therapy were similar to those determined in clinical trials. Our findings suggest that ICIs could be effective and well tolerated by people with advanced CSCC who are ineligible for clinical trials.

引用

页码：80 / 90

页数：11