Background and importance The therapeutic option in patients with metastatic non-small cell lung cancer (mNSCLC) after chemotherapy is based on the immune checkpoint inhibitors (ICI).
Aim and objectives The aim of this study was to analyse the effectiveness, safety and degree of compliance with criteria established in our hospital for patients with mNSCLC undergoing secondline treatment with immunotherapy.
Material and methods A retrospective descriptive study including patients with mNSCLC, receiving treatment with atezolizumab, nivolumab or pembrolizumab, from 1 December 2013 to 2 October 2019 was conducted. The electronic prescription programme in oncology and medical records were consulted. Data collected for each patient were sex, age, smoking status, performance status (PS), histology, actives brain metastases, EGFR/ALK/ROS-1 mutations, PDL-1 expression, therapeutic scheme and number of cycles received. Effectiveness was assessed in terms of progression free survival (PFS) and overall survival (OS), calculated by the Kaplan–Meier method. Adverse reactions (AR) of grade ≥3 were collected for analysis of safety. The conditions of use established were: PS=0–1 and patients without active brain metastases or EGFR/ALK/ROS-1 mutations.
Results Forty patients, 85% men, were included, with an average age of 70 (42–83) years, of whom 14 were current smokers and 23 were former smokers. A total of 37 patients presented at the beginning of treatment with PS ≤1. There were 18 lung adenocarcinomas and 22 with a non-squamous histology. No patient had active brain metastases at baseline or EGFR/ALK/ROS-1 mutations. PDL-1 expression was ≥1 in 17 patients. The schemes, average numbers and range of cycles were: atezolizumab 1200 mg every 3 weeks, 5 (1–14) cycles; nivolumab 3 mg/kg every 2 weeks, 12 (1–44) cycles; and pembrolizumab 2 mg/kg every 3 weeks, 6 (4–17) cycles. Median PFS and OS were 5 months (95% CI 2.9–7.1) and 14 months (95% CI 8.3–19.7), respectively. AR grade ≥3 reports were: asthenia (29%), pneumonitis (29%), renal disorder (14%), hyperglycaemia (14%) and gastrointestinal symptoms (14%). A total of 7.5% of patients did not comply with the conditions of use established at the start of treatment (PS ≥2).
Conclusion and relevance ICI demonstrated a clinical benefit in terms of PFS and OS. The most frequent grade ≥3 AR were asthenia and pneumonitis. Our study suggested a high percentage of compliance with the criteria established.
References and/or acknowledgements No conflict of interest.