Outcomes from salvage chemotherapy or pembrolizumab beyond progression with or without local ablative therapies for advanced non-small cell lung cancers with PD-L1 ≥50% who progress on first-line immunotherapy: real-world data from a European cohort

作者：Giulio Metro, Alfredo Addeo, Diego Signorelli, Alessio Gili, Panagiota Economopoulou, Fausto Roila, Giuseppe Luigi Banna, Alessandro De Toma, Juliana Rey Cobo, Andrea Camerini, Athina Christopoulou, Giuseppe Lo Russo, Marco Banini, Domenico Galetta, Beatriz Jiménez, Ana Collazo-Lorduy, Antonio Calles, Panagiotis Baxevanos, Helena Linardou, P. Kosmidis, Marina Chiara Garassino, Giannis Mountzios · 发表于：Journal of Thoracic Disease · 年份：2019 · DOI：10.21037/jtd.2019.12.23 · 被引用次数：44 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Diagnosis and Treatment、Radiomics and Machine Learning in Medical Imaging

BACKGROUND: In this real-world multicenter study we addressed the activity of post-progression anticancer treatments after first-line pembrolizumab in advanced non-small cell lung cancer (NSCLC) patients with PD-L1 ≥50%. METHODS: Clinico-pathological data of PD-L1 ≥50% advanced NSCLCs who failed first-line pembrolizumab were collected in 14 Oncologic Centers from different European countries. Types of subsequent anticancer treatment and outcomes on salvage chemotherapy or pembrolizumab beyond progression with or without the addition of local ablative therapies were reported. RESULTS: Out of 173 patients, 100 had progressed on pembrolizumab, of which 60 patients (60%) met eligibility criteria and were treated with either salvage chemotherapy (42/60, 70%) or pembrolizumab beyond progression (18/60, 30%). Overall, median age was 66 years, 63.3% were male, 60.0% had a performance status of 0-1, 88.3% were smokers and 61.7% had adenocarcinoma histology. In patients evaluable for response, objective response rate to salvage chemotherapy was 41.9%, with no significant difference according to the type of regimen (42.9% for platinum-based and 40.0% for single-agent chemotherapy). Median progression-free survival (PFS) to salvage chemotherapy was 4.5 months. Among patients treated with pembrolizumab beyond progression, 13 out of 18 patients (72.2%) had progressive disease in ≤2 organ sites, of whom 9 (69.2%) were managed with the addition of local ablative therapies consisting of radia...