Patient Selection for Anti-PD-1/PD-L1 Therapy in Advanced Non-Small-Cell Lung Cancer: Implications for Clinical Practice

Califano, Raffaele; Lal, Rohit; Lewanski, Conrad; Nicolson, Marianne; Ottensmeier, Christian; Popat, Sanjay; Hodgson, Matt; Postmus, Pieter E.

doi:10.2217/fon-2018-0330

Cited by 26 publications

(17 citation statements)

References 91 publications

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“…In the case we reported here, the patient had an unresectable HAL but achieved an overall survival of 52 months from multiple lines of treatment including chemotherapy and anti-PD1 therapy. 25 ICIs targeting PD-(L)1 represent a standard treatment option for patients with advanced NSCLC and have shown promising response in clinical treatment. 26 Positive PD-L1 expression, high tumor mutation burden and mismatch repair-deficient have been proposed as a potential predictor for response to ICI.…”

Section: Discussionmentioning

confidence: 99%

Anti-PD-1 Therapy Achieved Disease Control After Multiline Chemotherapy in Unresectable KRAS-Positive Hepatoid Lung Adenocarcinoma: A Case Report and Literature Review

Chen¹,

Han²,

Gao³

et al. 2020

OTT

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Hepatoid adenocarcinoma of the lung (HAL) is extremely rare and standardized treatment strategy for HAL has not been established. Patients with unresectable HAL have a shorter survival time ranges from 1 to 36 months. Here, we reported a 65-year-old female patient with unresectable alpha-fetoprotein-producing HAL harboring KRAS-G12V and no other targetable driver mutations. The patient was treated with multiple lines of chemotherapies followed by PD-1 inhibitor, sintilimab, due to positive staining of PD-L1, and achieved an overall survival of 52 months. Although the disease was under control, the patient experienced fifth-grade pneumonia and died after 6 months of anti-PD-1 treatment. This is the first case of KRAS-positive HAL patient achieved stable disease by PD-1 inhibitor, which may provide valuable information for the treatment strategy development of advanced HAL patients, and highlights the importance of molecular diagnosis in treatment decision-making.

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Section: Discussionmentioning

confidence: 99%

Anti-PD-1 Therapy Achieved Disease Control After Multiline Chemotherapy in Unresectable KRAS-Positive Hepatoid Lung Adenocarcinoma: A Case Report and Literature Review

Chen¹,

Han²,

Gao³

et al. 2020

OTT

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“…Tumors with high levels of MSI (MSI-H) upregulate immune checkpoint proteins, including PD-L1, enabling evasion of immune surveillance [ 8 , 9 ]. As response to anti-PD-1 therapies can vary from patient to patient and between tumor types [ 10 ], predictive biomarkers may identify patients more likely to benefit from such therapies [ 11 ]. Tumor PD-L1 expression has been established as a biomarker for patient selection for monotherapy with the anti-PD-1 monoclonal antibody pembrolizumab in multiple tumor types including advanced non-small-cell lung cancer (NSCLC), melanoma, cervical cancer, gastric cancer, head and neck squamous cell cancer and esophageal cancer [ 2 , 12–18 ], and MSI-H has been established as a tumor-agnostic biomarker for pembrolizumab monotherapy [ 2 , 19–21 ].…”

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confidence: 99%

Association of PD-L1 Expression with Prognosis Among Patients with Ten Uncommon Advanced Cancers

et al. 2020

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Aim: Programmed death ligand 1 (PD-L1) expression and high levels of microsatellite instability (MSI-H) may predict response to checkpoint inhibitors, but their prevalence and prognostic value are unknown in many cancers. Methods: We retrospectively evaluated PD-L1 combined positive score (CPS) and MSI-H and their association with clinical outcomes among patients with ten advanced uncommon cancers. Results: 398 of 426 patients (93%) had a valid PD-L1 result; most (242; 61%) had CPS ≥1. Prevalence of MSI-H tumors was 8/360. Median overall survival was shorter among patients with PD-L1 CPS ≥1 tumors after first-line treatment (23.0 vs 39.7 months, p = 0.014). Conclusion: PD-L1 was commonly expressed in solid tumors, and CPS ≥1 was associated with shorter overall survival. Prevalence of MSI-H was low.

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“…Recently, ICIs have been widely used in cancer therapy, including lung cancer (16-18). However, ICIs are known to exacerbate preexisting autoimmune disease (19, 20). Paraneoplastic syndromes are treatable with cancer therapy.…”

Section: Discussionmentioning

confidence: 99%

Synchronous Occurrence of Bazex Syndrome and Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome in a Patient with Lung Cancer

Aoshima

Karayama

Sagisaka³

et al. 2019

Intern. Med.

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A 69-year-old man developed bilateral polyarthritis, edematous extremities, and skin desquamation on the fingers and ears. He did not meet the criteria for any connective tissue disease, including rheumatoid arthritis. An examination revealed advanced lung cancer. His systemic manifestations were attributed to paraneoplastic Bazex syndrome and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. Treatment with pembrolizumab (an anti-programmed death-1 antibody) for lung cancer relieved his symptoms and shrank the lung tumor. Bazex and RS3PE syndromes are rare paraneoplastic diseases. We herein report this unique case of synchronous development of these two paraneoplastic syndromes in the presence of advanced lung cancer.

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Patient Selection for Anti-PD-1/PD-L1 Therapy in Advanced Non-Small-Cell Lung Cancer: Implications for Clinical Practice

Cited by 26 publications

References 91 publications

<p>Anti-PD-1 Therapy Achieved Disease Control After Multiline Chemotherapy in Unresectable <em>KRAS</em>-Positive Hepatoid Lung Adenocarcinoma: A Case Report and Literature Review</p>

<p>Anti-PD-1 Therapy Achieved Disease Control After Multiline Chemotherapy in Unresectable <em>KRAS</em>-Positive Hepatoid Lung Adenocarcinoma: A Case Report and Literature Review</p>

Association of PD-L1 Expression with Prognosis Among Patients with Ten Uncommon Advanced Cancers

Synchronous Occurrence of Bazex Syndrome and Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome in a Patient with Lung Cancer

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