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. 2022 Dec 29;11(1):83.
doi: 10.3390/biomedicines11010083.

Impact of Liver Metastases and Number of Metastatic Sites on Immune-Checkpoint Inhibitors Efficacy in Patients with Different Solid Tumors: A Retrospective Study

Madeleine Maugeais  1 , Julien Péron  1   2   3   4 , Stéphane Dalle  2   3   5 , Amélie Boespflug  2   3   5 , Michaël Duruissaux  2   3   6   7 , Pauline Corbaux  1 , Thibault Reverdy  1 , Gulsum Sahin  1 , Aurélie Rabier  1 , Jonathan Lopez  2   3   8   9 , Nathalie Freymond  3   10 , Denis Maillet  1   3   11
Affiliations

Impact of Liver Metastases and Number of Metastatic Sites on Immune-Checkpoint Inhibitors Efficacy in Patients with Different Solid Tumors: A Retrospective Study

Madeleine Maugeais et al. Biomedicines. .

Abstract

Background: ICIs have dramatically improved patient outcomes in different malignancies. However, the impact of liver metastases (LM) and number of metastatic sites (MS) remains unclear in patients treated with single-agent anti-PD(L)1. Methods: We aimed to assess the prognostic impact of LM and MS number on progression-free survival (PFS) and overall survival (OS) in a large single-arm retrospective multicentric cohort (IMMUCARE) of patients treated with anti-PD(L)-1 for different solid tumors. Results: A total of 759 patients were enrolled from January 2012 to October 2018. The primary tumor types were non-small cell lung cancer (71%), melanoma (19%), or urologic cancer (10%). At the time of ICI initiation, 167 patients (22%) had LM and 370 patients (49%) had more than MS. LM was associated with a shorter median PFS of 1.9 months (95% CI: 1.8−2.5) vs. 4.0 months (95% CI: 3.6−5.4) in patients without LM (p < 0.001). The median OS of patients with LM was of 5.2 months (95% CI: 4.0−7.7) compared with 12.8 months (95% CI: 11.2−15.1) (p < 0.001). Interestingly, LM were not associated with shorter PFS, or OS compared to other MS types (brain, bone, or lung) in patients with only one MS. Patients with multiple MS also had poor clinical outcomes compared to patients with only one MS. The presence of LM and MS number were independent prognostic factors on overall survival. Conclusion: The presence of LM or multiple MS were associated with poorer survival outcomes in patients treated with anti-PD(L)-1.

Keywords: PD1 inhibitors; PDL1 inhibitors; immune checkpoint inhibitors; liver metastases; metastatic sites; prognostic biomarkers.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Kaplan–Meier analyses. (A) Progression-free survival (PFS) according to metastatic site (MS) number (1 MS versus ≥2 ML). (B) Overall survival according to MS number (1 MS versus ≥2 MS).
Figure 3
Figure 3
Kaplan–Meier analyses. (A) Progression-free survival (PFS) according to the presence of liver metastases (LM). (B) Overall survival according to the presence of LM.
Figure 4
Figure 4
Kaplan–Meier Analyses. Progression-free survival (PFS) according to the presence of liver metastases in patients with multiple sites of metastasis, (A) and in patients with only one MS (B). Overall survival (OS) according to the presence of liver metastases in patients with multiple sites of metastasis (C) and in patients with only one MS (D).
Figure 5
Figure 5
Overall response rate (ORR) according to metastatic location type in the subgroup of patients with only one site of metastasis. Legend: CR—Complete response; PR—Partial response; SD—Stable disease; PD—Progressive disease; NE—Non-evaluable.
See this image and copyright information in PMC

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