Nationwide Survival Benefit after Implementation of First-Line Immunotherapy for Patients with Advanced NSCLC-Real World Efficacy

Mette T Mouritzen, Andreas Carus, Morten Ladekarl, Peter Meldgaard, Anders W M Nielsen, Anna Livbjerg, Jacob W Larsen, Halla Skuladottir, Charlotte Kristiansen, Kim Wedervang, Tine Schytte, Karin H Hansen, Anne-Cathrine Østby, Malene S Frank, Jakob Lauritsen, Jens B Sørensen, Seppo W Langer, Gitte F Persson, Jon L Andersen, Johanna M C FraryLars B Drivsholm, Charles Vesteghem, Heidi S Christensen, Birgitte Bjørnhart, Mette Pøhl

Abstract

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.

OriginalsprogEngelsk
Artikelnummer4846
TidsskriftCancers
Vol/bind13
Udgave nummer19
ISSN2072-6694
DOI
StatusUdgivet - 28 sep. 2021

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