Pembrolizumab plus chemotherapy-induced pneumonitis in chemo-naïve patients with non-squamous non-small cell lung cancer: A multicentre, retrospective cohort study

Daichi Fujimoto, Satoru Miura, Kenichi Yoshimura, Kazushige Wakuda, Yuko Oya, Toshihide Yokoyama, Takashi Yokoi, Tetsuhiko Asao, Motohiro Tamiya, Atsushi Nakamura, Hiroshige Yoshioka, Koji Haratani, Shunsuke Teraoka, Takaaki Tokito, Shuji Murakami, Akihiro Tamiya, Shoichi Itoh, Hiroshi Yokouchi, Satoshi Watanabe, Ou YamaguchiKeisuke Tomii, Nobuyuki Yamamoto

研究成果: ジャーナルへの寄稿学術論文査読

25 被引用数 (Scopus)

抄録

Introduction: Despite the extensive use of the combination of cytotoxic chemotherapy and programmed cell death protein 1/programmed death-ligand 1 checkpoint inhibitors for cancer treatment, the incidence and characteristics of pneumonitis caused by this combination therapy have not been examined in clinical settings. Methods: We conducted a 36-centre, retrospective cohort study in patients with chemo-naïve advanced non-squamous non-small cell lung cancer who received a combination of platinum, pemetrexed and pembrolizumab between December 2018 and June 2019. Results: The study comprised 299 patients. The most frequent grade ≥3 non-hematologic adverse event was pneumonitis. There were 37 patients (12.4%, 95% CI 8.9–16.7) with all-grade pneumonitis and 10 (3.3%, 95% CI 1.6–6.1) with grade ≥3 pneumonitis. Of these, 21 (7.0%, 95% CI 4.4–10.5) and 9 patients (3.0%, 95% CI 1.4–5.6) developed all-grade and grade ≥3 pneumonitis within 90 days after initiating the combination therapy, respectively. The median time to treatment failure and progression-free survival was 5.9 (95% CI 5.0–6.8) and 7.5 (95% CI 6.5–8.7) months, respectively. In the survival analysis after adjusting for immortal time bias, pneumonitis was independently associated with shorter progression-free survival (HR 1.99, 95% CI 1.07–3.69, P = 0.03) and overall survival (HR 3.03, 95% CI 1.12–8.20, P = 0.03). Conclusions: Treatment-related pneumonitis occurred at a higher rate in the real-world population than that reported previously; it led to worse survival outcomes. Pneumonitis requires more attention. Additional studies are required to improve the safety of this combination therapy.

本文言語英語
ページ(範囲)63-72
ページ数10
ジャーナルEuropean Journal of Cancer
150
DOI
出版ステータス出版済み - 06-2021
外部発表はい

All Science Journal Classification (ASJC) codes

  • 腫瘍学
  • 癌研究

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