Background and importance Anti-PD-L1 immunotherapy is used to treat secondline or later non-small cell lung cancer (NSCLC). These monoclonal antibodies are the therapy of choice against NSCLC in routine clinical practice.
Aim and objectives To evaluate the efficacy of anti-PD-L1 immunotherapy in clinical practice in NSCLC.
Material and methods This retrospective observational study (July 2017 to July 2020) evaluated the efficacy of atezolizumab, nivolumab and pembrolizumab in patients with NSCLC, in a tertiary hospital, after failing firstline chemotherapy. The study variables were progression free survival (PFS) and overall survival (OS). Patient data were obtained through the digital medical record and the Oncowin oncology pharmacy computer programme.
Results 85 patients were included (23 received atezolizumab, 47 received nivolumab and 15 pembrolizumab). Mean age was 66 years and 89.4% were men. After a follow-up of 72 months, median OS of atezolizumab was 15.75 months (95% CI 0.00 to 33.08), nivolumab 4.7 months (95% CI 2.87 to 6.58) and pembrolizumab 13.73 months (95% CI 4.47 to 22.99). Median PFS for atezolizumab was 6.83 months (95% CI 4.89 to 8.77), for nivolumab 3.12 months (95% CI 2.14 to 4.10) and for pembrolizumab 9.13 months (95% CI 0.48 to 17.70). Our results were compared with the results of pivotal clinical trials.
For atezolizumab, median PFS of our study was much higher than that of the OAK1 study. Median OS was also higher than that of the OAK and POPLAR2 studies. The PFS results from our study of nivolumab were similar to those obtained in the CheckMate-0573 and CheckMate-CA2090174 trials. For OS, we found a much smaller median than that of the pivotal trials. For pembrolizumab, median PFS was higher than that in the Keynote 010 trial,5 although the OS values were the same.
Conclusion and relevance Our data indicated that the efficacy of anti-PDL1 immunotherapy in patients with secondline NSCLC in clinical practice varies with respect to the results obtained in pivotal clinical trials, with a higher PFS and a similar OS, except for nivolumab, which was much lower. It would be interesting, in future studies, to increase the number of patients to confirm these data on the efficacy of anti-PDL1 immunotherapy.
Conflict of interest No conflict of interest