Real-world treatment efficacy of anti-programmed death-1 combined with anti-angiogenesis therapy in non-small cell lung cancer patients

Abstract

Anti-programmed death-1 (PD-1) therapy has been extensively used to treat cancer. Recently, the combination of immunotherapy and anti-angiogenic therapy has emerged as a novel treatment approach. Therefore, we designed a study to evaluate the real-world benefit of the combination of anti-PD-1 and anti-angiogenesis therapy in patients with non-small cell lung cancer (NSCLC). We obtained the medical records of patients at the Chinese People's Liberation Army General Hospital who received either nivolumab or pembrolizumab combined with anti-angiogenesis therapy from January 2015 to December 2018. The overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated for all patients. Sixty-nine patients with NSCLC were included in our study. The ORR was 31.9% (95% CI: 20.6–43.2%) and the median PFS was 8.37 months (95% CI: 6.5–10.0 months). The subgroup analysis statistically revealed a significant difference in ORR for patients receiving first-line treatment vs other lines, and the values were 58.8% (95% CI: 32.7–84.9%) compared with 23.1% (95% CI: 11.2–34.9%). We also observed a significant improvement in PFS, with a median value of 10.5 months (95% CI: 7.4–13.1 months) for patients without EGFR mutations and 5.4 months (95% CI: 4.0–6.3 months) for patients with EGFR mutations. The real-world ORR, PFS, and OS were comparable to previous clinical trials, despite the patients’ different baseline characteristics. Importantly, compared with patients having identified EGFR mutations, patients without EGFR mutations had a better PFS. Furthermore, these data support the use of anti-PD-1 combined with anti-angiogenesis therapy as a novel treatment approach for patients with NSCLC.

Superior efficacy of immunotherapy‐based combinations over monotherapy for EGFR‐mutant non‐small cell lung cancer acquired resistance to EGFR‐TKIs

“…Qiu et al recently reported a median PFS of 5.4 months in EGFR-mutant patients who received ICIs plus antiangiogenic drugs; however they did not provide a specific description of this setting. 32 This study, which complements existing studies, highlighted that immunotherapy, especially anti-PD-1, combined with different agents benefited pretreated EGFR-mutated NSCLC patients in a real-world setting.…”

Combination of Immune Checkpoint Inhibitors and Anti-Angiogenic Agents in Brain Metastases From Non-Small Cell Lung Cancer

“…A real-world retrospective study enrolled 69 patients with NSCLC to explore the efficacy of ICIs combining anti-angiogenesis therapy ( 57 ). Sixty-three (91.3%) patients were at stage IV and 16 (23.2%) had sensitizing EGFR mutations.…”

Efficacy and safety profile of combining programmed cell death‐1 (PD‐1) inhibitors and antiangiogenic targeting agents as subsequent therapy for advanced or metastatic non‐small cell lung cancer (NSCLC)

“…Median PFS was 6.0 months in patients who received the combination strategy as subsequent therapy, while longer in first-line therapy (13.1 months, 95% CI: 9.0-17.2 months). 18 However, this study failed to reveal the relationship between PD-L1 expression level and treatment efficacy and has possibly overestimated the efficacy of this combination strategy because there were 39 enrolled patients who also received chemotherapy in addition to immunotherapy and antiangiogenic therapy.…”