Efficacy, prognosis and safety analysis of anti-PD-1/PD-L1 inhibitor rechallenge in advanced lung cancer patients: a cohort study

Yang, Jin; Ran, Zhi Hua; Zhou, Jianping; Luo, Lifeng; Lyu, Mengchen; Liu, Fang; Sun, Xianwen; Zhou, Ling; Wang, Xiaofei; Bao, Zhiyao; Chen, Wei; Dumoulin, Daphne W; Gao, Beili; Xiang, Yi

doi:10.21037/tlcr-22-360

Cited by 9 publications

(4 citation statements)

References 34 publications

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“…Among them, ICIs combined with anti-angiogenic drugs have achieved gratifying results in the treatment of NSCLC, showing good efficacy and acceptable tolerance, and have certain clinical application prospects. It has become a hotspot in the research of anti-tumor programs ( 6 - 10 ).…”

Section: Introductionmentioning

confidence: 99%

Corneal ulcer development due to sintilimab-anlotinib combination therapy-induced dry eye: a case report

Xiang,

Lin,

Guan

et al. 2024

Transl Cancer Res

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Background Programmed cell death-1 (PD-1) inhibitors and anti-angiogenic drugs have become a hotspot in research of anti-tumor programs; however, they can also cause some rare drug-related adverse reactions. Immune checkpoint inhibitors (ICIs) cause adverse reactions in the body, collectively known as immune-related adverse events (irAEs). Ocular side effects can occur in both targeted and immunotherapy patients, including dry eye, blurred vision, uveitis, conjunctivitis, retinopathy, or thyroid eye disease. To our knowledge, this is the first case report describing corneal ulcers secondary to dry eye in a patient treated with the combination of PD-1 inhibitor sintilimab and multi-targeted receptor tyrosine kinase inhibitor (TKI) anlotinib. Case Description A 65-year-old woman with non-small cell lung cancer (NSCLC) and bone metastases, without pre-existing ocular conditions, experienced mild dry eye symptoms 1 month following treatment with sintilimab (200 mg q3w) in combination with anlotinib (12 mg q3w). Unrelieved dry eye symptoms occurred after the third cycle of chemotherapy, and she was diagnosed with dry eye syndrome. Subsequently, she received corneal protective lens, sodium hyaluronate eye drops, and prednisone treatment. Her corneal epithelial damage did not improve significantly, and within the following 2 months, her vision decreased in both eyes and progressed to bilateral corneal ulcers. Oral administration of sintilimab and anlotinib was interrupted, and treatments such as corticosteroids, anti-inflammatory drugs, and corneal repair were administered; however, both eyes presented with corneal subepithelial defect and corneal scarring. Due to a shortage of donors, no corneal transplantation surgery could be performed. Conclusions The development of corneal epithelial disorders in patients receiving target therapy and immunotherapy may not be reversed by reducing its dose. Although the condition is controlled with the use of glucocorticoids, some eye side effects cannot be cured. The timely detection and intervention of adverse effects of anti-tumor drugs by oncologists and ophthalmologists is critical for rational prescription. Ophthalmologists should be aware of eye side effects in patients using immunotherapy to ensure appropriate treatment and minimize potential eye complications such as dry eye, conjunctivitis, etc.

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Section: Introductionmentioning

confidence: 99%

Corneal ulcer development due to sintilimab-anlotinib combination therapy-induced dry eye: a case report

Xiang,

Lin,

Guan

et al. 2024

Transl Cancer Res

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“…In addition to the traditional gold standards overall survival (OS) and objective response rate (ORR), the unique evaluation standards for ICIs such as treatment-free time survival ( 5 ) and durable responses ( 6 ), which are distinctively clinical benefits of ICIs. ICIs rechallenge might be an effective therapy for patients who discontinue treatment due to immune-related adverse events (AEs) ( 7 ). ICIs have been shown to prolong the survival time of advanced lung cancer patients ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety analysis of anlotinib combined with PD-1 inhibitors in advanced non-small cell lung cancer: a retrospective cohort study

Ye¹,

Huang²,

Zhou³

et al. 2023

J Thorac Dis

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Background: Programmed cell death 1 (PD-1) inhibitors are beneficial for patients with advanced lung cancer. However, the population who will benefit from PD-1 inhibitors is limited, and their efficacy needs to be further improved. Antiangiogenic agents may regulate tumor microenvironment to improve immunotherapy efficacy. This real-world study sought to investigate the efficacy and safety of anlotinib combined with PD-1 inhibitors in the treatment of advanced non-small cell lung cancer (NSCLC).Methods: In total, 42 advanced NSCLC patients were included in this retrospective study. All the patients received anlotinib combined with PD-1 inhibitors from May 2020 to November 2022. The progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) of the patients were evaluated. Results:The patients had an overall median PFS of 5.721 months [95% confidence interval (CI): 1.365-10.076]. The median PFS and ORRs of the male patients compared to the female patients were 10.553 vs. 4.340 months, and 36.4% vs. 0.0%, respectively (P=0.010 and 0.041). The DCRs for the first-, second-, and third-line therapies were 100%, 83.3%, and 64.3%, respectively (P=0.096). In relation to the pathological types, the ORRs of the sarcoma, squamous, and adenocarcinoma patients were 100.0%, 33.3%, and 18.5%, respectively (P=0.025). The DCRs of patients with the tumor protein 53 (TP53) mutation, other status, and epidermal growth factor receptor (EGFR) mutations were 100.0%, 81.5%, and 40.0%, respectively (P=0.020). All-grade AEs occurred in 52.38% of the patients. The grade 3 AEs were hypertension (7.14%), pneumonia (2.38%), and oral mucositis (2.38%). In total, 3 patients discontinued treatment due to anemia, oral mucositis, and pneumonia, respectively.Conclusions: Anlotinib combined with PD-1 inhibitors has potentially good efficacy and a tolerated safety profile in the treatment of advanced NSCLC patients.

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“…With the development of new drugs and therapies, an improved understanding of the tumor immune escape and angiogenesis mechanism has revealed new possibilities for anti-cancer treatment. Over the years, the application of anti-programmed death-1 (PD-1) and anti-programmed death-ligand 1 (PD-L1) antibodies has demonstrated their superior efficacy and safety ( 10 , 11 ), and PD-L1-negative tumors can still respond to anti-PD-1 therapy ( 10 , 12 ). Apatinib is a novel oral tyrosine kinase inhibitor (TKI) that selectively targets vascular endothelial growth factor receptor 2 (VEGFR2).…”

Section: Introductionmentioning

confidence: 99%

Camrelizumab and apatinib combined with chemotherapy in perioperative effective therapy for advanced gastric carcinoma with peritoneal metastasis: a case report

Liang,

Fang,

Jiang

et al. 2023

J Gastrointest Oncol

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Background Peritoneal metastases (PMs) are the most frequent metastatic pattern with a very poor prognosis in stage IV gastric cancer (GC). An effective therapeutic option has yet to be established. Combination therapy of anti-angiogenesis therapy, immunotherapy and chemotherapy was first used in advanced GC for perioperative treatment in this case. Case Description A 39-year-old man was diagnosed with stage IV GC with PM (CY1, P1) and the patient had an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 1 and adequate organ function. After disease progression on the first-line chemotherapy of paclitaxel plus S-1, the patient received a transformational therapy of camrelizumab (immune checkpoint inhibitors) plus apatinib (anti-angiogenic agent) combined with chemotherapy leading to macroscopic disappearance of the peritoneal lesions, negative peritoneal cytology, and the absence of other distant metastases, rendering him suitable to accept a radical gastrectomy with D2 lymph node dissection. The postoperative histopathology showed a tumor regression rate of more than 90%. Later, the patient was admitted for adjuvant therapy of camrelizumab plus apatinib combined with chemotherapy and relapsed at around 8 months after surgery. Treatment was well tolerated with no significant adverse effects. Conclusions Camrelizumab plus apatinib combined with chemotherapy as second-line treatment demonstrated feasible anti-tumor activity and manageable safety in this advanced GC patient with PM and provided an opportunity for radical resection, improving the objective response rate (ORR) and prolonging patient survival. The incorporation may overcome resistance to treatment with therapy alone and produce synergistic effects, indicating a promising treatment option in the clinic to GC with PM.

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Efficacy, prognosis and safety analysis of anti-PD-1/PD-L1 inhibitor rechallenge in advanced lung cancer patients: a cohort study

Cited by 9 publications

References 34 publications

Corneal ulcer development due to sintilimab-anlotinib combination therapy-induced dry eye: a case report

Corneal ulcer development due to sintilimab-anlotinib combination therapy-induced dry eye: a case report

Efficacy and safety analysis of anlotinib combined with PD-1 inhibitors in advanced non-small cell lung cancer: a retrospective cohort study

Camrelizumab and apatinib combined with chemotherapy in perioperative effective therapy for advanced gastric carcinoma with peritoneal metastasis: a case report

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