The Effect of Pleural Effusion on Prognosis in Patients with Non-Small Cell Lung Cancer Undergoing Immunochemotherapy: A Retrospective Observational Study

被引：6

作者：

Nishimura, Tomoka ^{[1
]}

Ichihara, Eiki ^{[2
]}

Yokoyama, Toshihide ^{[3
]}

Inoue, Koji ^{[4
]}

Tamura, Tomoki ^{[5
]}

Sato, Ken ^{[6
]}

Oda, Naohiro ^{[7
]}

Kano, Hirohisa ^{[8
]}

Kishino, Daizo ^{[9
]}

Kawai, Haruyuki ^{[10
]}

Inoue, Masaaki ^{[11
]}

Ochi, Nobuaki ^{[12
]}

Fujimoto, Nobukazu ^{[13
]}

Ichikawa, Hirohisa ^{[14
]}

Ando, Chihiro ^{[1
]}

Hotta, Katsuyuki ^{[15
]}

Maeda, Yoshinobu ^{[1
]}

Kiura, Katsuyuki ^{[2
]}

机构：

[1] Okayama Univ, Dept Hematol & Oncol, Grad Sch Med Dent & Pharmaceut Sci, Okayama 7008558, Japan

[2] Okayama Univ Hosp, Dept Allergy & Resp Med, Okayama 7008558, Japan

[3] Kurashiki Cent Hosp, Ohara Healthcare Fdn, Dept Resp Med, Kurashiki 7108602, Japan

[4] Ehime Prefectural Cent Hosp, Dept Resp Med, Matsuyma 7900024, Japan

[5] NHO Iwakuni Clin Ctr, Dept Resp Med, Iwakuni 7408510, Japan

[6] Natl Hosp Org Okayama Med Ctr, Dept Resp Med, Okayama 7011192, Japan

[7] Fukuyama City Hosp, Dept Internal Med, Fukuyama 7218511, Japan

[8] Japanese Red Cross Okayama Hosp, Dept Resp Med, Okayama 7008607, Japan

[9] Japanese Red Cross Soc Himeji Hosp, Dept Resp Med, Himeji 6708540, Japan

[10] Okayama Saiseikai Gen Hosp, Dept Internal Med, Okayama 7000021, Japan

[11] Shimonoseki City Hosp, Dept Chest Surg, Shimonoseki 7508520, Japan

[12] Kawasaki Med Sch, Dept Gen Internal Med 4, Okayama 7008505, Japan

[13] Okayama Rosai Hosp, Dept Resp Med, Okayama 7028055, Japan

[14] KKR Takamatsu Hosp, Dept Resp Med, Takamatsu 7600018, Japan

[15] Okayama Univ Hosp, Ctr Innovat Clin Med, Okayama 7008558, Japan

来源：

CANCERS | 2022年 / 14卷 / 24期

关键词：

pleural effusion; non-small cell carcinoma; immune checkpoint inhibitors; IMMUNOTHERAPY; NIVOLUMAB; DOCETAXEL; IMPACT; VEGF;

D O I：

10.3390/cancers14246184

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Simple Summary Minimal data exists on pleural effusion (PE) for non-small cell lung cancer (NSCLC) patients undergoing combined ICI and chemotherapy. We retrospectively investigated how PE affects survival outcomes in patients with NSCLC undergoing this combined therapy. We identified 478 patients who underwent combined ICI therapy and chemotherapy; 357 patients did not have PE, and 121 patients did have PE. Patients with PE had significantly shorter progression-free survival and overall survival than those without PE. In addition, bevacizumab-containing regimens did not improve the survival outcomes for patients with PE. In conclusion, PE was associated with poor outcomes among patients with NSCLC undergoing combined ICI therapy and chemotherapy. Objectives: Combined immune checkpoint inhibitor (ICI) therapy and chemotherapy has become the standard treatment for advanced non-small-cell lung cancer (NSCLC). Pleural effusion (PE) is associated with poor outcomes among patients with NSCLC undergoing chemotherapy. However, minimal data exists on PE for patients undergoing combined ICI and chemotherapy. Therefore, we investigated how PE affects survival outcomes in patients with NSCLC undergoing this combined therapy. Methods: We identified patients with advanced NSCLC undergoing chemotherapy and ICI therapy from the Okayama Lung Cancer Study Group-Immune Chemotherapy Database (OLCSG-ICD) between December 2018 and December 2020; the OLCSG-ICD includes the clinical data of patients with advanced NSCLC from 13 institutions. Then, we analyzed the treatment outcomes based on the presence of PE. Results: We identified 478 patients who underwent combined ICI therapy and chemotherapy; 357 patients did not have PE, and 121 patients did have PE. Patients with PE had significantly shorter progression-free survival (PFS) and overall survival (OS) than those without PE (median PFS: 6.2 months versus 9.1 months; p < 0.001; median OS: 16.4 months versus 27.7 months; p < 0.001). The negative effect of PE differed based on the patient's programmed cell death-ligand 1 (PD-L1) expression status; with the effect being more evident in patients with high PD-L1 expression. In addition, PFS and OS did not differ between patients who did and did not undergo bevacizumab treatment; thus, bevacizumab-containing regimens did not improve the survival outcomes for patients with PE. Conclusion: PE is associated with poor outcomes among patients with NSCLC undergoing combined ICI therapy and chemotherapy.

引用

页数：10

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