Real-world outcomes of nivolumab plus ipilimumab and pembrolizumab with platinum-based chemotherapy in advanced non-small cell lung cancer: a multicenter retrospective comparative study

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2024年1月4日

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Kinnosuke Matsumoto,
Takayuki Shiroyama,
Motohiro Tamiya,
Toshiyuki Minami,
Yuhei Kinehara,
Akihiro Tamiya,
Yasuhiko Suga,
Tomoki Kuge,
Masahide Mori,
Hidekazu Suzuki,
Satoshi Tobita,
Kiyonobu Ueno,
Yoshinobu Namba,
Satoshi Tetsumoto,
Toshie Niki,
Osamu Morimura,
Akio Osa,
Kazumi Nishino,
Izumi Nagatomo,
Yoshito Takeda,
Takashi Kijima,
Atsushi Kumanogoh

摘要

Introduction

Nivolumab plus ipilimumab with chemotherapy (NICT) and pembrolizumab with chemotherapy (PCT) are commonly used in patients with advanced non-small cell lung cancer (NSCLC). Compared with immune checkpoint inhibitor (ICI) monotherapy, ICI combination therapy can increase immune-related toxicity instead of prolonging survival. This study aimed to compare the efficacy and safety of NICT and PCT to decide on the favorable treatment.

Methods

We conducted a multi-center retrospective cohort study on patients who underwent NICT or PCT between December 2018 and May 2022. Propensity score matching (PSM) was performed with the variables age, sex, smoking status, performance status, stage, histology, and programmed cell death ligand-1 (PD-L1). The Kaplan–Meier method was used to compare survival for the matched patients.

Results

Six hundred consecutive patients were included. After PSM, 81 and 162 patients were enrolled in the NICT and PCT groups, respectively. The baseline characteristics were well-balanced. The median progression-free survival was equivalent (11.6 vs. 7.4 months; P = 0.582); however, the median overall survival (OS) was significantly longer in the NICT group than in the PCT group (26.0 vs. 16.8 months; P = 0.005). Furthermore, OS was better in PD-L1-negative patients who underwent NICT than in those who underwent PCT (26.0 vs. 16.8 months; P = 0.045). Safety profiles did not differ significantly in terms of severe adverse event and treatment-related death rates (P = 0.560, and 0.722, respectively).

Conclusions

Real-world data suggests that NICT could be a favorable treatment option compared with PCT for patients with advanced NSCLC. Further follow-up is needed to determine the long-term prognostic benefit.