The clinical utility and safety of short-course immune checkpoint inhibitors in multiple tumours-A real-world multicentric study from India

被引:8
作者
Abraham, George [1 ]
Noronha, Vanita [1 ]
Rajappa, Senthil [2 ]
Agarwal, Amit [3 ]
Batra, Ullas [4 ]
Somani, Naresh [5 ]
Raja, Thirumalairaj [6 ]
Patil, Shekhar [7 ]
Kaushal, Ashish M. [8 ]
Joshi, Ashish [9 ]
Radhakrishnan, Vivek [10 ]
Singh, Navneet [11 ]
Babu, Govind [12 ]
Tewani, Rohan [2 ]
Baghmar, Saphalta [3 ]
Dodagoudar, Chandragouda [3 ]
Ananthakrishnan, Ramya [6 ]
Poppareddy, Shashidhara Haragadde [7 ]
Sharma, Vibhor [13 ]
Menon, Nandini [1 ]
Patil, Vijay M. [1 ]
Joshi, Amit [1 ]
Gupta, Sudeep [1 ]
Prabhash, Kumar [1 ]
Bajpai, Jyoti [1 ]
机构
[1] Tata Mem Hosp, Dept Med Oncol, Room 1115,11th Floor,Homi Bhabha Block, Mumbai 400012, Maharashtra, India
[2] Basavatarakam Indo Amer Canc Hosp & Res Inst, Dept Med Oncol, Hyderabad, India
[3] BLK Superspecial Hosp, Dept Med Oncol, Delhi, India
[4] Rajiv Gandhi Canc Inst & Res Ctr, Dept Med Oncol, Delhi, India
[5] HCG Canc Ctr, Dept Med Oncol, Jaipur, Rajasthan, India
[6] Apollo Hosp, Dept Med Oncol, Chennai, Tamil Nadu, India
[7] HCG Canc Ctr, Dept Med Oncol, Bengaluru, India
[8] HCG Canc Ctr, Dept Med Oncol, Ahmadabad, Gujarat, India
[9] Mumbai Oncocare Ctr, Dept Med Oncol, Mumbai, Maharashtra, India
[10] Tata Med Ctr, Dept Med Oncol, Kolkata, India
[11] Post Grad Inst Med Educ & Res, Dept Med Oncol, Chandigarh, India
[12] Kidwai Mem Inst Oncol, Dept Med Oncol, Bengaluru, India
[13] Paras Hosp, Dept Med Oncol, Gurgaon, India
关键词
immune checkpoint inhibitors; low-dose; low-middle income countries; multicentric; short-course therapy; POOLED ANALYSIS; PHASE-III; PEMBROLIZUMAB; IPILIMUMAB;
D O I
10.1002/ijc.33868
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The real-world data on short course of immune checkpoint inhibitor (ICI) use are sparse and merit exploration. A multicentric observational study on the safety and efficacy of ICI in oncology patients between August 2014 and October 2020 involves 1011 patients across 13 centers in India. The median age was 59 (min 16-max 98) years with male preponderance (77.9%). The predominant cohort received short-course ICI therapy; the median number of cycles was 5 (95% confidence interval [CI] 1-27), and the median duration of therapy was 3 (95% CI 0.5-13) months. ICIs were used commonly in the second and third line setting in our study (66.4%, n = 671). Objective response rate (complete or partial response) was documented in 254 (25.1%) of the patients, 202 (20.0%) had stable disease, and 374 (37.0%) had progressive disease. The clinical benefit rate was present in 456 (45.1%). Among the patients whom ICI was stopped (n = 906), the most common reason for cessation of ICI was disease progression (616, 68.0%) followed by logistic reasons like financial constraints (234, 25.82%). With a median follow-up of 14.1 (95% CI 12.9-15.3) months, there were 616 events of progression and 443 events of death, and the median progression free survival and overall survival were 6.4 (95% CI 5.5-7.3) and 13.6 (95% CI 11.6-15.7) months, respectively, in the overall cohort. Among the immune-related adverse events, autoimmune pneumonitis (29, 3.8%) and thyroiditis (24, 2.4%) were common. Real-world multicentric Indian data predominantly with short-course ICI therapy have comparable efficacy/safety to international literature with standard ICI therapy.
引用
收藏
页码:1045 / 1052
页数:8
相关论文
共 41 条
[1]   Overall Survival with Durvalumab after Chemoradiotherapy in Stage III NSCLC [J].
Antonia, S. J. ;
Villegas, A. ;
Daniel, D. ;
Vicente, D. ;
Murakami, S. ;
Hui, R. ;
Kurata, T. ;
Chiappori, A. ;
Lee, K. H. ;
de Wit, M. ;
Cho, B. C. ;
Bourhaba, M. ;
Quantin, X. ;
Tokito, T. ;
Mekhail, T. ;
Planchard, D. ;
Kim, Y. -C. ;
Karapetis, C. S. ;
Hiret, S. ;
Ostoros, G. ;
Kubota, K. ;
Gray, J. E. ;
Paz-Ares, L. ;
Carpeno, J. de Castro ;
Faivre-Finn, C. ;
Reck, M. ;
Vansteenkiste, J. ;
Spigel, D. R. ;
Wadsworth, C. ;
Melillo, G. ;
Taboada, M. ;
Dennis, P. A. ;
Ozguroglu, M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2018, 379 (24) :2342-2350
[2]   Immune checkpoint inhibitors in malignancy [J].
Ardolino, Luke ;
Joshua, Anthony .
AUSTRALIAN PRESCRIBER, 2019, 42 (02) :62-67
[3]   New Math on Drug Cost-Effectiveness [J].
Bach, Peter B. .
NEW ENGLAND JOURNAL OF MEDICINE, 2015, 373 (19) :1797-1799
[4]   Short course pembrolizumab in complete responders with advanced non-small cell lung cancer. [J].
Chan, Daniel Boon Yeow .
JOURNAL OF CLINICAL ONCOLOGY, 2017, 35
[5]   Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification [J].
Cheson, Bruce D. ;
Fisher, Richard I. ;
Barrington, Sally F. ;
Cavalli, Franco ;
Schwartz, Lawrence H. ;
Zucca, Emanuele ;
Lister, T. Andrew .
JOURNAL OF CLINICAL ONCOLOGY, 2014, 32 (27) :3059-+
[6]  
Cottrell TR, 2018, CANCER J, V24, P41, DOI 10.1097/PPO.0000000000000301
[7]   Prognostic role of chemotherapy-induced neutropenia in first-line treatment of advanced ovarian cancer. A pooled analysis of MITO2 and MITO7 trials [J].
Daniele, Gennaro ;
Arenare, Laura ;
Scambia, Giovanni ;
Pisano, Carmela ;
Sorio, Roberto ;
Breda, Enrico ;
De Placido, Sabino ;
Savarese, Antonella ;
Ferrandina, Gabriella ;
Raspagliesi, Francesco ;
Panici, Pierluigi Benedetti ;
Ferro, Antonella ;
Rimanti, Anita ;
Cormio, Gennaro ;
Lorusso, Domenica ;
Cecere, Sabrina Chiara ;
Scalone, Simona ;
Marsico, Valentina Angela ;
Cardalesi, Cinzia ;
Cognetti, Francesco ;
Salutari, Vanda ;
Attademo, Laura ;
Guizzaro, Lorenzo ;
Schettino, Clorinda ;
Piccirillo, Maria Carmela ;
Perrone, Francesco ;
Gallo, Ciro ;
Pignata, Sandro .
GYNECOLOGIC ONCOLOGY, 2019, 154 (01) :83-88
[8]   Immune checkpoint inhibitors: recent progress and potential biomarkers [J].
Darvin, Pramod ;
Toor, Salman M. ;
Nair, Varun Sasidharan ;
Elkord, Eyad .
EXPERIMENTAL AND MOLECULAR MEDICINE, 2018, 50 :1-11
[9]   Progress of immune checkpoint therapy in the clinic [J].
Fan, Yiqun ;
Zhang, Chi ;
Jin, Shengjie ;
Gao, Zhihui ;
Cao, Jun ;
Wang, Aoqing ;
Li, Dawei ;
Wang, Qian ;
Sun, Xing ;
Bai, Dousheng .
ONCOLOGY REPORTS, 2019, 41 (01) :3-14
[10]   Evaluation of dosing strategy for pembrolizumab for oncology indications [J].
Freshwater, Tomoko ;
Kondic, Anna ;
Ahamadi, Malidi ;
Li, Claire H. ;
de Greef, Rik ;
de Alwis, Dinesh ;
Stone, Julie A. .
JOURNAL FOR IMMUNOTHERAPY OF CANCER, 2017, 5