Characterizing the Shifting Real-World Treatment Landscape by PD-L1 Testing Status and Expression Level in Advanced Non-Small Cell Lung Cancer,Advances in Therapy

当前位置： X-MOL 学术 › Adv. Ther. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Characterizing the Shifting Real-World Treatment Landscape by PD-L1 Testing Status and Expression Level in Advanced Non-Small Cell Lung Cancer
Advances in Therapy ( IF 3.4 ) Pub Date : 2022-08-10 , DOI: 10.1007/s12325-022-02260-9
Wenzhen Ge ₁ , Ning Wu ₁ , Ruben G W Quek ₁ , Jinjie Liu ₂ , Jean-Francois Pouliot ₁ , Hilary Dietz ₃ , Jessica J Jalbert ₁ , James Harnett ₁ , Scott J Antonia ₃

Affiliation

Introduction

Contemporary real-world data on advanced non-small cell lung cancer (aNSCLC) treatment patterns across programmed cell death-ligand 1 (PD-L1) expression levels and testing status are limited.

Methods

A retrospective cohort was selected of adults newly diagnosed with aNSCLC between January 1, 2018, and July 31, 2021, who initiated first-line treatments, which were described by PD-L1 status and expression levels (≥ 50%, 1–49%, < 1%). Treatment received before and after PD-L1 test results were described for patients initiating first-line treatment before PD-L1 results. For patients who initiated chemotherapy alone before PD-L1 results, the probability of receiving immune checkpoint inhibitors (ICIs) after PD-L1 results was estimated by PD-L1 level and associated factors were explored.

Results

Among 12,202 patients with aNSCLC initiating first-line treatment [54.7% male, mean (standard deviation) age 69.2 (9.4) years], the most common therapies were ICI-based regimens across PD-L1 levels, and chemotherapy alone among PD-L1-untested patients. Use of chemotherapy alone decreased between 2018 and 2019 and stabilized thereafter, accounting for 21–29% of first-line treatments across PD-L1 levels and 48% of untested patients in 2021. Of 1468 patients initiating first-line treatment before PD-L1 results, treatments remained unchanged in most patients after PD-L1 results. Among patients initiating chemotherapy alone before PD-L1 results, the probability of receiving ICIs within 45 days after test results was 40.5% [95% confidence interval (CI) 31.6–48.3%], 28.6% (95% CI 20.3–36.0%), and 22.9% (95% CI 16.9–28.4%) at PD-L1 ≥ 50%, 1–49%, and < 1%, respectively.

Conclusion

While ICI-based regimens accounted for most first-line treatments across PD-L1 levels, chemotherapy alone was initiated in > 20% of patients tested for PD-L1 and 48% of untested patients in 2021. Patients who initiated chemotherapy alone had a low probability of receiving ICIs after PD-L1 test results. These results highlight the need for understanding the role and timing of PD-L1 test results for informing treatment decisions for patients with aNSCLC.

中文翻译：

通过 PD-L1 检测状态和晚期非小细胞肺癌的表达水平表征不断变化的现实世界治疗格局

介绍

关于程序性细胞死亡配体 1 (PD-L1) 表达水平和测试状态的晚期非小细胞肺癌 (aNSCLC) 治疗模式的当代真实世界数据是有限的。

方法

回顾性队列选择了 2018 年 1 月 1 日至 2021 年 7 月 31 日期间新诊断为 aNSCLC 的成年人，他们开始了一线治疗，这些治疗通过 PD-L1 状态和表达水平（≥ 50%，1-49%）来描述, < 1%)。对于在 PD-L1 结果之前开始一线治疗的患者，描述了在 PD-L1 检测结果之前和之后接受的治疗。对于在 PD-L1 结果之前单独开始化疗的患者，通过 PD-L1 水平估计在 PD-L1 结果之后接受免疫检查点抑制剂 (ICI) 的概率，并探讨了相关因素。

结果

在 12,202 名开始一线治疗的 aNSCLC 患者中 [54.7% 男性，平均（标准差）年龄 69.2（9.4）岁]，最常见的治疗是跨 PD-L1 水平的基于 ICI 的方案，以及单独化疗在 PD-L1 水平-未经测试的患者。单独化疗的使用在 2018 年至 2019 年期间减少，此后稳定下来，占 PD-L1 水平一线治疗的 21-29%，占 2021 年未经测试患者的 48%。在 PD-L1 之前开始一线治疗的 1468 名患者中结果显示，大多数患者在 PD-L1 结果出炉后的治疗保持不变。在 PD-L1 结果前单独开始化疗的患者中，在检测结果后 45 天内接受 ICI 的概率为 40.5% [95% 置信区间 (CI) 31.6–48.3%]、28.6% (95% CI 20.3–36.0%) , 和 22.9% (95% CI 16.9–28.4%) 在 PD-L1 ≥ 50%, 1–49%, 和 <

结论

虽然基于 ICI 的方案占 PD-L1 水平的大多数一线治疗，但在 2021 年，超过 20% 接受 PD-L1 测试的患者和 48% 未接受测试的患者开始单独化疗。 PD-L1 测试结果后接受 ICI 的概率。这些结果突出表明需要了解 PD-L1 检测结果的作用和时机，以告知 aNSCLC 患者的治疗决策。

更新日期：2022-08-11

点击分享查看原文

点击收藏

公开下载

阅读更多本刊新发论文本刊介绍/投稿指南