Efficacy and clinicogenomic biomarkers of response to dual versus single agent checkpoint inhibitor therapy in untreated metastatic non-small cell lung cancer.

作者：Daniel Boiarsky, Lingzhi Hong, Biagio Ricciuti, Alissa J. Cooper, Maliazurina B. Saad, Arielle Elkrief, Alessandro Di Federico, Muhammad Aminu, Waree Rinsurongkawong, Jeff Lewis, Don L. Gibbons, Ara A. Vaporciyan, Xiuning Le, J. Jack Lee, John V. Heymach, Jia Wu, Adam J. Schoenfeld, Mark M. Awad, Jianjun Zhang, Natalie I. Vokes · 发表于：Journal of Clinical Oncology · 年份：2024 · DOI：10.1200/jco.2024.42.16_suppl.8549 · 被引用次数：1 · 研究领域：Lung Cancer Treatments and Mutations、Lung Cancer Research Studies、Cancer Genomics and Diagnostics

8549 Background: Biomarkers to guide the application of CTLA-4 inhibitors with anti-PD-(L)1 in untreated EGFR/ALK-negative metastatic non-small cell lung cancer (mNSCLC) are underexplored. Methods: Patients with ECOG performance status 0-1 and untreated EGFR/ALK-negative mNSCLC who received dual immune checkpoint inhibitor (ICI) therapy, or single agent PD-(L)1 inhibitor alone (ICI-mono) or with chemotherapy (ICI-chemo) at three institutions were analyzed. Clinical progression-free survival (PFS), and overall survival (OS) were the primary outcomes. Patients with progressive disease (PD) or stable disease (SD) as per RECIST 1.1 were considered non-responders, whereas those with partial or complete response (PR/CR) were considered responders. Inverse propensity weighting (IPW) for clinical and sociodemographic characteristics was used to control for differences in treatment selection. To identify subgroups of patients who benefit from dual ICI therapy, we conducted IPW multivariate analysis, including clinico-genomic covariates alone and in interaction with treatment assignment. Results: A total of 2347 patients (48% female, median age 67; dual ICI 255, ICI-mono 789, ICI-chemo 1303) were included. In unadjusted analysis, as compared to ICI-mono or ICI-chemo, dual IC was associated with an increase in OS (ICI-mono: HR = 0.8, p = 0.011; ICI-chemo: HR = 0.7, p = 4.7e-05) and a relatively smaller increase in PFS (ICI-mono: HR = 0.8, p = 0.041; ICI-chemo: HR = 0.9, p = 0.076). Amon...