Efficacy of ICIs on patients with oncogene-driven non-small cell lung cancer: a retrospective study

Guo, Xiaojin; He, Du; Li, Jiayu; Yang, Mian; Xiong, Anweng; Zhang, Haiping; Wu, Fengying

doi:10.20517/cdr.2021.85

Cited by 6 publications

(6 citation statements)

References 28 publications

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“…A meta-analysis reported that patients with EGFR mutations did not benefit from ICI monotherapy as a second-line therapy compared to docetaxel [9]. Consistent with prior findings [22][23][24], the EGFR subtype in the present study did not benefit from ICI treatment in terms of mPFS across all subgroups, even for the high-TPS group (≥50%).…”

Section: Discussionsupporting

confidence: 86%

Real-World Outcomes of Immunotherapy in Second- or Later-Line Non-Small Cell Lung Cancer with Actionable Genetic Alterations

Jun,

Park,

Sun

et al. 2023

Cancers

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Introduction: While the efficacy of immune checkpoint inhibitors (ICIs) in treating non-small cell lung cancer (NSCLC) patients with actionable genetic alterations (AGAs) is modest, certain patients demonstrate improved survival. Thus, this study aimed to evaluate the benefits of ICIs in NSCLC patients with diverse AGAs and verify the predictive biomarkers of ICI efficacy. Methods: From January 2018 to July 2022, this study compared the progression-free survival (PFS) of NSCLC patients with different AGAs treated with ICI monotherapy as second- or later-line therapy at Samsung Medical Center. To ascertain the predictors of ICIs efficacy, we adjusted ICIs’ effects on PFS in terms of clinical and molecular biomarkers. Results: EGFR (46.0%) was the most prevalent mutation in 324 patients. In multivariate analysis, PD-L1 positivity (tumor proportion score (TPS) ≥ 1%) (HR = 0.41) and the use of steroids for immune-related adverse events (HR = 0.46) were positive factors for ICI therapy in the AGAs group. Co-existing mutation of STK11 with KRAS mutation (HR = 4.53) and TP53 with MET mutation (HR = 9.78) was negatively associated with survival. Conclusions: The efficacy of ICI treatment varied across AGA subtypes, but patients with KRAS, MET, and BRAF mutations demonstrated relatively long-duration benefits of ICI therapy. PD-L1 was a significant positive predictive biomarker in all AGA groups.

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Section: Discussionsupporting

confidence: 86%

Real-World Outcomes of Immunotherapy in Second- or Later-Line Non-Small Cell Lung Cancer with Actionable Genetic Alterations

Jun,

Park,

Sun

et al. 2023

Cancers

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“…Currently, immunotherapy or immunochemotherapy, depending on the level of PD-L1 expression, remains the standard of care for the first-line treatment of NSCLC. This also applies to patients with the p.G12C mutation in the KRAS gene, in whom the efficacy of immune checkpoint inhibitors is comparable to that in other patients [40][41][42][43][44][45]. Clinical trials are underway to evaluate the value of sotorasib in combination with other cancer drugs in first-line treatment (NCT05920356, NCT04933695) [46,47].…”

Section: Discussionmentioning

confidence: 99%

Sotorasib for non-small cell lung cancer — current options and perspectives

Knetki-Wróblewska,

Wasąg

2024

Oncol Clin Pract

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KRAS regulates several cellular processes, such as cell proliferation, cell cycle regulation, metabolic changes, cell survival, and cell differentiation. Abnormalities in the KRAS gene are found in approximately 30% of patients with non-small cell lung cancer, usually in patients diagnosed with nonsquamous cancer and more often in Caucasian patients, women, and smokers. The p.G12C variant is most frequently found in KRAS-positive patients. Sotorasib is the first drug approved for this population. The superiority of sotorasib over docetaxel after failure of immunochemotherapy was demonstrated in the CodeBreak 200 phase III study for the primary endpoint -median progression-free survival was 5.6 months [95% confidence interval (CI) 4.3-7.8] vs. 4.5 months (3.0-5.7); hazard ratio = 0.66 (95% CI 0.51-0.86; p = 0-0017), while the 12-month progression-free survival rate was 24.8% for sotorasib and 10.1% for docetaxel. Currently, sotorasib monotherapy, at an initial dose of 960 mg/day, is indicated for use in adults with advanced non-small cell lung cancer with the KRAS p.G12C mutation who have experienced disease progression after at least one previous line of systemic treatment. More randomized trials are needed to determine the optimal place of sotorasib in the systemic treatment sequence in this patient population.

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“…Thirdly, recent research [44] showed that several gene alterations (such as EGFR-mutant, ROS1 rearrangement, HER2 mutation) may affect the efficacy of immunotherapy in NSCLC.…”

Section: Discussionmentioning

confidence: 99%

Predicting the efficacy of immune checkpoint inhibitors monotherapy in advanced non-small cell lung cancer: a machine learning method based on multidimensional data

Liu¹,

Liang²,

Lu³

et al. 2023

neo

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Immunotherapy has improved the prognosis of patients with advanced non-small cell lung cancer (NSCLC), but only a small subset of patients achieved clinical benefit. The purpose of our study was to integrate multidimensional data using a machine learning method to predict the therapeutic efficacy of immune checkpoint inhibitors (ICIs) monotherapy in patients with advanced NSCLC. We retrospectively enrolled 112 patients with stage IIIB-IV NSCLC receiving ICIs monotherapy. The random forest (RF) algorithm was used to establish efficacy prediction models based on five different input datasets, including precontrast computed tomography (CT) radiomic data, postcontrast CT radiomic data, a combination of the two CT radiomic data, clinical data, and a combination of radiomic and clinical data. The 5-fold cross-validation was used to train and test the random forest classifier. The performance of the models was assessed according to the area under the curve (AUC) in the receiver operating characteristic curve. Survival analysis was performed to determine the difference in progression-free survival (PFS) between the two groups with the prediction label generated by the combined model. The radiomic model based on the combination of precontrast and postcontrast CT radiomic features and the clinical model produced an AUC of 0.92 ± 0.04 and 0.89 ± 0.03, respectively. By integrating radiomic and clinical features together, the combined model had the best performance with an AUC of 0.94 ± 0.02. The survival analysis showed that the two groups had significantly different PFS times (p < 0.0001). The baseline multidimensional data including CT radiomic and multiple clinical features were valuable in predicting the efficacy of ICIs monotherapy in patients with advanced NSCLC.

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Efficacy of ICIs on patients with oncogene-driven non-small cell lung cancer: a retrospective study

Cited by 6 publications

References 28 publications

Real-World Outcomes of Immunotherapy in Second- or Later-Line Non-Small Cell Lung Cancer with Actionable Genetic Alterations

Real-World Outcomes of Immunotherapy in Second- or Later-Line Non-Small Cell Lung Cancer with Actionable Genetic Alterations

Sotorasib for non-small cell lung cancer — current options and perspectives

Predicting the efficacy of immune checkpoint inhibitors monotherapy in advanced non-small cell lung cancer: a machine learning method based on multidimensional data

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