Prognostic Variables Associated With Improved Outcomes in Patients With Stage III NSCLC Treated With Chemoradiation Followed by Consolidation Pembrolizumab: A Subset Analysis of a Phase II Study From the Hoosier Cancer Research Network LUN 14-179

Anouti, Bilal; Althouse, Sandra K.; Durm, Greg Andrew; Hanna, Nasser H.

doi:10.1016/j.cllc.2019.06.009

Cited by 13 publications

(11 citation statements)

References 7 publications

(8 reference statements)

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“…At a median follow‐up of 18.6 months, median PFS was 17.0 months (95% CI: 11.9–NX), with 12–18‐ and 24‐month PFS rates of 60.2%, 49.9%, and 44.6%, respectively. At the time of this analysis, median OS had not yet been reached, and 12–18‐ and 24‐month OS rates were 81.0%, 68.0%, and 61.9%, respectively 20 . These two trials confirmed that ICIs including both anti‐PD‐1 and anti‐PD‐L1 could be used as consolidation therapy to prolong OS and PFS of patients with locally advanced NSCLC.…”

Section: Discussionmentioning

confidence: 70%

“…Herein, we found that 12-month PFS in patients undergoing ICI consolidation therapy following CRT was 89.5%, which was promising given that the 12-month PFS observed in the PACIFIC study was 55.7%. 10 The PACIFIC trial was a randomized, placebo-controlled, double-blinded, multicenter analysis of 713 locally advanced NSCLC patients which found that durvalumab 20 These two trials confirmed that ICIs including both anti-PD-1 and anti-PD-L1 could be used as consolidation therapy to prolong OS and PFS of patients with locally advanced NSCLC. In this study, we included patients treated with both anti-PD-1 and anti-PD-L1.…”

Section: Discussionmentioning

confidence: 92%

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Efficacy and safety of immune checkpoint inhibitor consolidation after chemoradiation in patients of Asian ethnicity with unresectable stage III non‐small cell lung cancer: Chinese multicenter report and literature review

Zhang

et al. 2020

Thoracic Cancer

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Background: The PACIFIC study has defined a new standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC) in the form of immune checkpoint inhibitor (ICI) consolidation therapy. However, there is little specific data pertaining to the safety and efficacy of this approach in Chinese NSCLC patients. Methods: This was a prospective multicenter cohort study. Between September 2018 and January 2020, patients with unresectable stage III NSCLC that had undergone chemoradiation therapy (CRT) and ICI consolidation treatment were enrolled in this study. The short-term safety, tolerability, and efficacy of ICI combination with CRT were evaluated in these patients. Results: Of the 20 Chinese patients eligible for inclusion, 17 (85.0%) underwent concurrent CRT treatment. In these patients, a median period of 40.5 days (range: 1-85 days) passed between the end of CRT and initiation of consolidation therapy. Pneumonitis occurred in 80.0% of patients, with seven (35.0%) being diagnosed with grade 1 pneumonitis and nine (45.0%) with grade 2 pneumonitis. No patients experienced grade 3 or higher pneumonitis or other ICI-related toxicities. Lung V20 ≥ 20% was associated with higher grade 2 pneumonitis (77.8%; ≥20% vs. 18.2%; <20%, P = 0.027). The overall response rate (ORR) in these patients was 95.0%. Over a median follow-up period of 11.3 months (range: 6.2-21.8 months), 12-month PFS of these patients were 89.5% (95% CI: 76.7-100.0%), and 12 months OS was 100.0%. Conclusions: These data indicate that ICI consolidation therapy can achieve favorable short-term efficacy, while exhibiting good safety and acceptable toxicity profiles in Chinese patients with unresectable stage III NSCLC.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 92%

Efficacy and safety of immune checkpoint inhibitor consolidation after chemoradiation in patients of Asian ethnicity with unresectable stage III non‐small cell lung cancer: Chinese multicenter report and literature review

Zhang

et al. 2020

Thoracic Cancer

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“…The median OS was 22.4 months, the median PFS was 17 months, and the 2-year survival rate was 61.9%. Prolonging pembrolizumab treatment may be associated with prolonged PFS and OS, but unfortunately, not all patients benefit from consolidation immunotherapy ( 10 ). Studies also found that, combining with anti-EGFR antibody cetuximab did not improve overall survival ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

“…The Pacific study ( 9 ) showed that among patients with stage III unresectable NSCLC, the combination of standard concurrent chemoradiotherapy and durvalumab significantly prolonged overall survival compared with placebo (hazard ratio: 0.68; P = 0.0025) with similar safety as placebo. Meanwhile, previous studies have demonstrated no further benefit in survival prolongation with combination therapies based on CCRT or afatinib, like pembrolizumab ( 10 ), or cetuximab ( 11 ). Also, increasing the radiation dose to 74 Gy (high dose) paradoxically decreased survival compared with CCRT ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

A Multicenter Retrospective Study on the Prognosis of Stage III Unresectable Mutant Non-Small Cell Lung Cancer With Tyrosine Kinase Inhibitors Therapy

et al. 2021

Front. Oncol.

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BackgroundFor unresectable stage III non-small cell lung cancer (NSCLC), concurrent chemoradiotherapy is nowadays the standard treatment. Patients with advanced NSCLC harboring driver-gene mutations benefit from Tyrosine Kinase Inhibitors (TKIs) Therapy. In a real-world setting, there is room for exploring the benefit of TKIs in stage III unresectable NSCLC patients with mutation.MethodsA total of 81 patients from the Jinling Hospital and the Jiangsu Cancer Hospital with stage III unresectable mutant NSCLC applied targeted therapy were enrolled in this retrospective study. Patients with first-line application of TKIs were followed up to gain the situation of surgery qualifications, progression-free survival and overall survival, so as to evaluate the survival prognosis, then whether patients benefit and what kind of patients benefit most from TKI monotherapy treatment or its combination are explored.ResultsThe median progression-free survival of involved 81 patients was 13.87 months (95% confidence interval (CI): 11.66–16.08), and the median survival was 41.47 months (95%CI: 20.11–62.83). The 5-year survival rates were 91.0, 80.3, 56.1, 45.5, and 32.5%, respectively. After first-line TKI therapy, seven patients (8.6%) were reevaluated as eligible for surgery and proceeded to surgery. Although no characteristics were found to be statistical prognostic, younger female non-smokers still tended to have a better prognosis with longer progression free survival and overall survival.ConclusionsTKIs are a viable option for mutant stage III unresectable NSCLC patients who have achieved good clinical benefit from TKI. Patients who cannot tolerate chemoradiotherapy, especially those with driver gene mutations, can choose targeted therapy for first-line treatment.

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“…Although there is no longer a requirement for high PD‐L1 expression, patients with advanced NSCLC and high expression of PD‐L1 will benefit more from ICI treatment 9 . In addition, a recent phase II study showed that pembrolizumab might be efficient for patients with stage III NSCLC after chemoradiation, whose OS and PFS were similar to that achieved with durvalumab in the PACIFIC trial 10 . Therefore, consolidation immunotherapy should be recommended for subsequent treatment in patients with stage III NSCLC after concurrent chemoradiation.…”

Section: Case Summarymentioning

confidence: 99%

Complete response induced by anti–PD‐1‐based immunotherapy with toripalimab in a patient with locally advanced lung adenocarcinoma who failed rapidly after concurrent chemoradiotherapy: A case report

et al. 2020

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What is known and objective Several immune checkpoint inhibitors (ICIs) are now available for treatment of non‐small cell lung cancer (NSCLC). However, not all patients benefit from ICI therapy, and the choice of ICIs is limited. Case summary A 54‐year‐old man with locally advanced NSCLC achieved partial response after definitive chemoradiotherapy. When he opted for consolidation therapy, metastatic lesions were found. Surprisingly, after immunotherapy with toripalimab, he quickly achieved complete response. What is new and conclusion As a PD‐1 inhibitor, toripalimab may be an effective option for subsequent therapy of patients with locally advanced NSCLC after concurrent chemoradiotherapy.

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Prognostic Variables Associated With Improved Outcomes in Patients With Stage III NSCLC Treated With Chemoradiation Followed by Consolidation Pembrolizumab: A Subset Analysis of a Phase II Study From the Hoosier Cancer Research Network LUN 14-179

Cited by 13 publications

References 7 publications

Efficacy and safety of immune checkpoint inhibitor consolidation after chemoradiation in patients of Asian ethnicity with unresectable stage III non‐small cell lung cancer: Chinese multicenter report and literature review

Efficacy and safety of immune checkpoint inhibitor consolidation after chemoradiation in patients of Asian ethnicity with unresectable stage III non‐small cell lung cancer: Chinese multicenter report and literature review

A Multicenter Retrospective Study on the Prognosis of Stage III Unresectable Mutant Non-Small Cell Lung Cancer With Tyrosine Kinase Inhibitors Therapy

Complete response induced by anti–PD‐1‐based immunotherapy with toripalimab in a patient with locally advanced lung adenocarcinoma who failed rapidly after concurrent chemoradiotherapy: A case report

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