TY - JOUR
T1 - Nationwide Survival Benefit after Implementation of First-Line Immunotherapy for Patients with Advanced NSCLC-Real World Efficacy
AU - Mouritzen, Mette T
AU - Carus, Andreas
AU - Ladekarl, Morten
AU - Meldgaard, Peter
AU - Nielsen, Anders W M
AU - Livbjerg, Anna
AU - Larsen, Jacob W
AU - Skuladottir, Halla
AU - Kristiansen, Charlotte
AU - Wedervang, Kim
AU - Schytte, Tine
AU - Hansen, Karin H
AU - Østby, Anne-Cathrine
AU - Frank, Malene S
AU - Lauritsen, Jakob
AU - Sørensen, Jens B
AU - Langer, Seppo W
AU - Persson, Gitte F
AU - Andersen, Jon L
AU - Frary, Johanna M C
AU - Drivsholm, Lars B
AU - Vesteghem, Charles
AU - Christensen, Heidi S
AU - Bjørnhart, Birgitte
AU - Pøhl, Mette
PY - 2021/9/28
Y1 - 2021/9/28
N2 - Background The selection of patients with non-small cell lung cancer (NSCLC) for immune checkpoint inhibitor (ICI) treatment remains challenging. This real-world study aimed to compare the overall survival (OS) before and after the implementation of ICIs, to identify OS prognostic factors, and to assess treatment data in first-line (1L) ICI-treated patients without epidermal growth factor receptor mutation or anaplastic lymphoma kinase translocation. Methods Data from the Danish NSCLC population initiated with 1L palliative antineoplastic treatment from 1 January 2013 to 1 October 2018, were extracted from the Danish Lung Cancer Registry (DLCR). Long-term survival and median OS pre- and post-approval of 1L ICI were compared. From electronic health records, additional clinical and treatment data were obtained for ICI-treated patients from 1 March 2017 to 1 October 2018. Results The OS was significantly improved in the DLCR post-approval cohort (n = 2055) compared to the pre-approval cohort (n = 1658). The 3-year OS rates were 18% (95% CI 15.6-20.0) and 6% (95% CI 5.1-7.4), respectively. On multivariable Cox regression, bone (HR = 1.63) and liver metastases (HR = 1.47), performance status (PS) 1 (HR = 1.86), and PS ≥ 2 (HR = 2.19) were significantly associated with poor OS in ICI-treated patients. Conclusion OS significantly improved in patients with advanced NSCLC after ICI implementation in Denmark. In ICI-treated patients, PS ≥ 1, and bone and liver metastases were associated with a worse prognosis.
AB - Background The selection of patients with non-small cell lung cancer (NSCLC) for immune checkpoint inhibitor (ICI) treatment remains challenging. This real-world study aimed to compare the overall survival (OS) before and after the implementation of ICIs, to identify OS prognostic factors, and to assess treatment data in first-line (1L) ICI-treated patients without epidermal growth factor receptor mutation or anaplastic lymphoma kinase translocation. Methods Data from the Danish NSCLC population initiated with 1L palliative antineoplastic treatment from 1 January 2013 to 1 October 2018, were extracted from the Danish Lung Cancer Registry (DLCR). Long-term survival and median OS pre- and post-approval of 1L ICI were compared. From electronic health records, additional clinical and treatment data were obtained for ICI-treated patients from 1 March 2017 to 1 October 2018. Results The OS was significantly improved in the DLCR post-approval cohort (n = 2055) compared to the pre-approval cohort (n = 1658). The 3-year OS rates were 18% (95% CI 15.6-20.0) and 6% (95% CI 5.1-7.4), respectively. On multivariable Cox regression, bone (HR = 1.63) and liver metastases (HR = 1.47), performance status (PS) 1 (HR = 1.86), and PS ≥ 2 (HR = 2.19) were significantly associated with poor OS in ICI-treated patients. Conclusion OS significantly improved in patients with advanced NSCLC after ICI implementation in Denmark. In ICI-treated patients, PS ≥ 1, and bone and liver metastases were associated with a worse prognosis.
KW - real-world evidence
KW - cancer immunotherapy
KW - immune checkpoint inhibitors
KW - anti-PD-1
KW - first-line treatment
KW - non-small cell lung cancer
KW - advanced lung cancer
KW - clinical prognostic factors
KW - overall survival
KW - Danish registry
U2 - 10.3390/cancers13194846
DO - 10.3390/cancers13194846
M3 - Article
C2 - 34638329
SN - 2072-6694
VL - 13
JO - Cancers
JF - Cancers
IS - 19
ER -