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Multicenter Study
. 2024 Oct;42(5):538-546.
doi: 10.1007/s10637-024-01467-7. Epub 2024 Aug 21.

Depth of response and treatment outcomes of immune checkpoint inhibitor-based therapy in patients with advanced non-small cell lung cancer and high PD-L1 expression: An exploratory analysis of retrospective multicenter cohort

Yusuke Tachibana #  1 , Kenji Morimoto #  1 , Tadaaki Yamada  2 , Hayato Kawachi  1 , Motohiro Tamiya  3 , Yoshiki Negi  4 , Yasuhiro Goto  5 , Akira Nakao  6 , Shinsuke Shiotsu  7 , Keiko Tanimura  8 , Takayuki Takeda  8 , Asuka Okada  9 , Taishi Harada  10 , Koji Date  11 , Yusuke Chihara  12 , Isao Hasegawa  13 , Nobuyo Tamiya  14 , Yuki Katayama  1 , Naoya Nishioka  1 , Masahiro Iwasaku  1 , Shinsaku Tokuda  1 , Takashi Kijima  4 , Koichi Takayama  1
Affiliations
Multicenter Study

Depth of response and treatment outcomes of immune checkpoint inhibitor-based therapy in patients with advanced non-small cell lung cancer and high PD-L1 expression: An exploratory analysis of retrospective multicenter cohort

Yusuke Tachibana et al. Invest New Drugs. 2024 Oct.

Abstract

The association between depth of response (DpR) and treatment outcomes has been documented across various types of cancer. Immune checkpoint inhibitor (ICI)-based treatment is globally used as first-line treatment for non-small cell lung cancer (NSCLC) with programmed death-ligand 1 (PD-L1) expression ≥ 50%. However, in this population, the significance of DpR is not elucidated. Patients with advanced NSCLC and PD-L1 expression ≥ 50% who received ICI-monotherapy or ICI plus chemotherapy were retrospectively enrolled into this study. Treatment responses were grouped into DpR 'quartiles' by percentage of maximal tumor reduction (Q1 = 1-25%, Q2 = 26-50%, Q3 = 51-75%, and Q4 = ≥ 76%), and no tumor reduction (NTR). The association between DpR and survival rates were determined using hazard ratios (HR) generated by the Cox proportional hazards model. The Kaplan-Meier method was used to determine survival outcomes. A total of 349 patients were included, of which 214 and 135 patients received pembrolizumab monotherapy and ICI plus chemotherapy, respectively, as first-line treatments. The majority of the patients were male. All DpR quartiles, especially Q4, showed an association with progression-free survival (PFS)/overall survival (OS). In the Q4 cohort, patients who received pembrolizumab had a longer PFS than those who received ICI plus chemotherapy. High DpR was associated with longer PFS and OS, with a more pronounced effect observed with pembrolizumab monotherapy than with ICI plus chemotherapy.

Keywords: Chemoimmunotherapy; Depth of response; Immune checkpoint inhibitor; Non-small cell lung cancer; Tumor shrinkage.

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Conflict of interest statement

Declarations. Ethics approval: All procedures involving human participants performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The review board of each institution approved the study protocol. Informed consent: The requirement for informed consent from patients was waived owing to the retrospective nature of the study, and an opt-out method was included so that patients and families could opt out of participating in the study. Competing interests: The authors declare no competing interests.

References

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