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Multicenter Study
. 2023 Jul;14(21):2069-2076.
doi: 10.1111/1759-7714.14992. Epub 2023 Jun 8.

Platinum-combination chemotherapy with or without immune-checkpoint inhibitor in patients with postoperative recurrent non-small cell lung cancer previously treated with adjuvant platinum-doublet chemotherapy: A multicenter retrospective study

Kakeru Hisakane  1 , Takehiro Tozuka  2 , Satoshi Takahashi  3 , Namiko Taniuchi  4 , Nobuhiko Nishijima  4 , Kenichiro Atsumi  1 , Tetsuya Okano  3 , Masahiro Seike  2 , Takashi Hirose  1
Affiliations
Multicenter Study

Platinum-combination chemotherapy with or without immune-checkpoint inhibitor in patients with postoperative recurrent non-small cell lung cancer previously treated with adjuvant platinum-doublet chemotherapy: A multicenter retrospective study

Kakeru Hisakane et al. Thorac Cancer. 2023 Jul.

Abstract

Background: Rechallenge with platinum-combination chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) after disease progression on platinum-combination chemotherapy occasionally leads to a favorable response. The efficacy and safety of platinum-combination chemotherapy with or without immune-checkpoint inhibitor (ICI) for patients with recurrent NSCLC after surgery followed by adjuvant platinum-doublet chemotherapy remains uncertain.

Methods: Patients who relapsed after surgery plus adjuvant platinum-doublet chemotherapy and received platinum-combination chemotherapy with or without ICI between April 2011 and March 2021 at four Nippon Medical School hospitals were retrospectively analyzed.

Results: Among 177 patients who received adjuvant platinum-doublet chemotherapy after surgery, a total of 30 patients who received platinum-combination rechemotherapy with or without ICI after relapse were included in this study. Seven patients received ICI-combined chemotherapy. The median disease-free survival (DFS) after surgery was 13.6 months. The objective response rate and disease-control rate were 46.7% and 80.0%, respectively. The median progression-free survival and overall survival were 10.2 and 37.5 months, respectively. Patients with longer DFS (≥12 months) had a better prognosis than others. The most common grade ≥3 toxicity associated with this treatment was neutropenia (33%). Grade ≥3 immune-related adverse events were pneumonitis (14%) and colitis (14%). Treatment-related deaths did not occur in this study.

Conclusion: Platinum-combination chemotherapy with or without ICI for patients with postoperative recurrent NSCLC who previously received adjuvant platinum-doublet chemotherapy was effective and safe. In particular, this therapy may be promising for patients with longer DFS.

Keywords: immune-checkpoint inhibitor; non-small cell lung cancer; platinum-combination chemotherapy; postoperative recurrence.

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Conflict of interest statement

M. Seike received funding from Taiho Pharmaceutical, Chugai Pharmaceutical, and MSD; and honoraria for lectures from Taiho Pharmaceutical, Chugai Pharmaceutical, Ono Pharmaceutical, Bristol‐Meyers Squibb, and MSD. T. Hirose received funding from Taiho Pharmaceutical, and Chugai Pharmaceutical; and honoraria for lectures from Taiho Pharmaceutical, Chugai Pharmaceutical, Bristol‐Meyers Squibb, and MSD. The other authors have no potential conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Patient inclusion flowchart. ICI, immune‐checkpoint inhibitor.
FIGURE 2
FIGURE 2
Kaplan–Meier curves for progression‐free survival (a) and overall survival (b) in all patients.
FIGURE 3
FIGURE 3
Kaplan–Meier curves for progression‐free survival (a) and overall survival (b) in all patients according to disease‐free survival (DFS).
See this image and copyright information in PMC

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