Real-World Data of Different Immune Checkpoint Inhibitors for Non-Small Cell Lung Cancer in China

Abstract

BackgroundPatients treated with immunotherapy in the real-world may have significantly different responses to those meeting inclusion criteria for random controlled clinical studies. There is a partial overlap in approved indications for the use of the different immune checkpoint inhibitors (ICIs) currently available. A comprehensive assessment of the efficacy, safety and economic effects of various ICIs is a problem that clinicians need to address.MethodsAnalyzed real-world data was collected from non-small cell lung cancer (NSCLC) patients who were treated with ICIs from hospitalized patients in the Lung Cancer Center of Peking Union Medical College Hospital between 2018 and 2021. The objectives were to evaluate the efficacy and safety of different ICIs for the treatment of NSCLC in China and to investigate the factors affecting their curative effects.ResultsOverall, 351 patients were included in the retrospective study. The median PFS for the NSCLC patient cohort treated with medication regimens that included ICIs was 9.5 months, with an ORR of 47.3%. There were no significant discrepancies in efficacy and safety between the different ICIs administered. Factors that had the greatest impact on the efficacy of ICIs were the disease stage, ECOG-PS scores and treatment lines. Gender, age, smoking history, PD-L1 TPS expression, history of targeted therapy and irAEs all had a degree of influence on patient prognosis.ConclusionsThe study reports the experience of real-world usage of ICIs for the treatment of NSCLC patients in China. The results were generally consistent with those of clinical trials, while the efficacy and safety of different ICIs exhibited no statistically significant differences. Therefore, physicians can make a comprehensive choice based on the indications and cost of different ICIs and the preferences of patients.

Clinical effects and emerging issues of atezolizumab plus bevacizumab in patients with advanced hepatocellular carcinoma from Japanese real‐world practice

“…One study of realworld data on non-small cell lung cancer from China demonstrated that the efficacy of immunotherapies was poorer after second-or later-line treatment than after first-line treatment. 29 Taken together with these data and our results, the efficacy of atezolizumab plus bevacizumab may not be expected to be sufficient if atezolizumab plus bevacizumab is used after other systemic therapies. Nowadays, the majority of patients with advanced HCC selected atezolizumab plus bevacizumab as first-line systemic therapy in Japanese clinical practice based on the guidelines.…”

“…The initial report with its short observation period, including 20 patients, showed differences in ORRs according to RECIST version 1.1 between the first‐line treatment group and second‐ or later‐line treatment group (26% vs. 0%). One study of real‐world data on non–small cell lung cancer from China demonstrated that the efficacy of immunotherapies was poorer after second‐ or later‐line treatment than after first‐line treatment 29 . Taken together with these data and our results, the efficacy of atezolizumab plus bevacizumab may not be expected to be sufficient if atezolizumab plus bevacizumab is used after other systemic therapies.…”

Induction chemoimmunotherapy may improve outcomes to chemoradiotherapy for unresectable stage III NSCLC patients

“…Furthermore, the relatively small number of patients treated with induction chemoimmunotherapy and the subsequent analysis in the cCRT/sCRT setting further reduced the sample size, which, together with the relatively shorter follow-up period, may also affect the results. Finally, although this study did not distinguish the e cacy of different ICIs, a previous study reported no signi cant difference in the e cacy and safety among variable ICIs [23]. Nevertheless, future studies should focus on an identical ICI agent.…”

A Multicenter Study on the Challenges and Real-World Utilization of Immune Checkpoint Inhibitors in Resource-Constrained Settings: Insights and Implications from India

“…In this multicenter series on the use of ICIs from India, the responses and outcomes were comparable to those realworld data reported in literatures. [1][2][3][4] Financial constraints were the major factor limiting the use if ICIs. This was 4.6 months, and the median OS was 15.4 months.…”