Cargando…
Response and outcomes after anti-CTLA4 versus anti-PD1 combined with stereotactic body radiation therapy for metastatic non-small cell lung cancer: retrospective analysis of two single-institution prospective trials
BACKGROUND: This study compared response rates and outcomes of combined radiotherapy and immunotherapy (iRT) based on the type of checkpoint inhibitor (anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA4) vs antiprogrammed death-1 (PD1)) for metastatic non-small cell lung cancer (mNSCLC). METHOD...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057428/ https://www.ncbi.nlm.nih.gov/pubmed/31996395 http://dx.doi.org/10.1136/jitc-2019-000492 |
_version_ | 1783503656207777792 |
---|---|
author | Chen, Dawei Menon, Hari Verma, Vivek Guo, Chunxiao Ramapriyan, Rishab Barsoumian, Hampartsoum Younes, Ahmed Hu, Yun Wasley, Mark Cortez, Maria Angelica Welsh, James |
author_facet | Chen, Dawei Menon, Hari Verma, Vivek Guo, Chunxiao Ramapriyan, Rishab Barsoumian, Hampartsoum Younes, Ahmed Hu, Yun Wasley, Mark Cortez, Maria Angelica Welsh, James |
author_sort | Chen, Dawei |
collection | PubMed |
description | BACKGROUND: This study compared response rates and outcomes of combined radiotherapy and immunotherapy (iRT) based on the type of checkpoint inhibitor (anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA4) vs antiprogrammed death-1 (PD1)) for metastatic non-small cell lung cancer (mNSCLC). METHODS: We retrospectively reviewed two prospective trials of radiation combined with anti-CTLA4 or anti-PD1 for patients with mNSCLC. Patients undergoing non-salvage stereotactic body radiation therapy (SBRT) to lung sites were selected from both trials and grouped by the immunotherapeutic compound received. Endpoints included in-field and out-of-field response rates, and overall response rate (complete or partial response) (all by response evaluation criteria in solid tumors). Progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method. RESULTS: Median follow-up times for the 33 patients (n=17 SBRT+anti-CTLA4, n=16 SBRT+anti-PD1) were 19.6 and 19.9 months. Response rates for out-of-field lesions were similar between anti-PD1 (37%) and anti-CTLA4 (24%) (p=0.054). However, global response rates for all lesions were 24% anti-CTLA4 vs 56% anti-PD1 (p=0.194). The PFS was 76% for anti-CTLA4 vs 94% anti-PD1 at 3 months, 52% vs 87% at 6 months, 31% vs 80% at 12 months, and 23% vs 63% at 18 months (p=0.02). Respective OS values were 76% vs 87% at 6 months, 47% vs 80% at 12 months, and 39% vs 66% at 18 months (p=0.08). CONCLUSIONS: Both anti-CTLA4 and anti-PD1 agents prompt a similar degree of in-field and out-of-field responses after iRT, although the global response rate and PFS were statistically higher in the anti-PD1 cohort. Further dedicated study and biological mechanistic assessment is required. TRIAL REGISTRATION NUMBERS: NCT02239900 and NCT02444741. |
format | Online Article Text |
id | pubmed-7057428 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-70574282020-03-05 Response and outcomes after anti-CTLA4 versus anti-PD1 combined with stereotactic body radiation therapy for metastatic non-small cell lung cancer: retrospective analysis of two single-institution prospective trials Chen, Dawei Menon, Hari Verma, Vivek Guo, Chunxiao Ramapriyan, Rishab Barsoumian, Hampartsoum Younes, Ahmed Hu, Yun Wasley, Mark Cortez, Maria Angelica Welsh, James J Immunother Cancer Short Report BACKGROUND: This study compared response rates and outcomes of combined radiotherapy and immunotherapy (iRT) based on the type of checkpoint inhibitor (anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA4) vs antiprogrammed death-1 (PD1)) for metastatic non-small cell lung cancer (mNSCLC). METHODS: We retrospectively reviewed two prospective trials of radiation combined with anti-CTLA4 or anti-PD1 for patients with mNSCLC. Patients undergoing non-salvage stereotactic body radiation therapy (SBRT) to lung sites were selected from both trials and grouped by the immunotherapeutic compound received. Endpoints included in-field and out-of-field response rates, and overall response rate (complete or partial response) (all by response evaluation criteria in solid tumors). Progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method. RESULTS: Median follow-up times for the 33 patients (n=17 SBRT+anti-CTLA4, n=16 SBRT+anti-PD1) were 19.6 and 19.9 months. Response rates for out-of-field lesions were similar between anti-PD1 (37%) and anti-CTLA4 (24%) (p=0.054). However, global response rates for all lesions were 24% anti-CTLA4 vs 56% anti-PD1 (p=0.194). The PFS was 76% for anti-CTLA4 vs 94% anti-PD1 at 3 months, 52% vs 87% at 6 months, 31% vs 80% at 12 months, and 23% vs 63% at 18 months (p=0.02). Respective OS values were 76% vs 87% at 6 months, 47% vs 80% at 12 months, and 39% vs 66% at 18 months (p=0.08). CONCLUSIONS: Both anti-CTLA4 and anti-PD1 agents prompt a similar degree of in-field and out-of-field responses after iRT, although the global response rate and PFS were statistically higher in the anti-PD1 cohort. Further dedicated study and biological mechanistic assessment is required. TRIAL REGISTRATION NUMBERS: NCT02239900 and NCT02444741. BMJ Publishing Group 2020-01-28 /pmc/articles/PMC7057428/ /pubmed/31996395 http://dx.doi.org/10.1136/jitc-2019-000492 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Short Report Chen, Dawei Menon, Hari Verma, Vivek Guo, Chunxiao Ramapriyan, Rishab Barsoumian, Hampartsoum Younes, Ahmed Hu, Yun Wasley, Mark Cortez, Maria Angelica Welsh, James Response and outcomes after anti-CTLA4 versus anti-PD1 combined with stereotactic body radiation therapy for metastatic non-small cell lung cancer: retrospective analysis of two single-institution prospective trials |
title | Response and outcomes after anti-CTLA4 versus anti-PD1 combined with stereotactic body radiation therapy for metastatic non-small cell lung cancer: retrospective analysis of two single-institution prospective trials |
title_full | Response and outcomes after anti-CTLA4 versus anti-PD1 combined with stereotactic body radiation therapy for metastatic non-small cell lung cancer: retrospective analysis of two single-institution prospective trials |
title_fullStr | Response and outcomes after anti-CTLA4 versus anti-PD1 combined with stereotactic body radiation therapy for metastatic non-small cell lung cancer: retrospective analysis of two single-institution prospective trials |
title_full_unstemmed | Response and outcomes after anti-CTLA4 versus anti-PD1 combined with stereotactic body radiation therapy for metastatic non-small cell lung cancer: retrospective analysis of two single-institution prospective trials |
title_short | Response and outcomes after anti-CTLA4 versus anti-PD1 combined with stereotactic body radiation therapy for metastatic non-small cell lung cancer: retrospective analysis of two single-institution prospective trials |
title_sort | response and outcomes after anti-ctla4 versus anti-pd1 combined with stereotactic body radiation therapy for metastatic non-small cell lung cancer: retrospective analysis of two single-institution prospective trials |
topic | Short Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057428/ https://www.ncbi.nlm.nih.gov/pubmed/31996395 http://dx.doi.org/10.1136/jitc-2019-000492 |
work_keys_str_mv | AT chendawei responseandoutcomesafterantictla4versusantipd1combinedwithstereotacticbodyradiationtherapyformetastaticnonsmallcelllungcancerretrospectiveanalysisoftwosingleinstitutionprospectivetrials AT menonhari responseandoutcomesafterantictla4versusantipd1combinedwithstereotacticbodyradiationtherapyformetastaticnonsmallcelllungcancerretrospectiveanalysisoftwosingleinstitutionprospectivetrials AT vermavivek responseandoutcomesafterantictla4versusantipd1combinedwithstereotacticbodyradiationtherapyformetastaticnonsmallcelllungcancerretrospectiveanalysisoftwosingleinstitutionprospectivetrials AT guochunxiao responseandoutcomesafterantictla4versusantipd1combinedwithstereotacticbodyradiationtherapyformetastaticnonsmallcelllungcancerretrospectiveanalysisoftwosingleinstitutionprospectivetrials AT ramapriyanrishab responseandoutcomesafterantictla4versusantipd1combinedwithstereotacticbodyradiationtherapyformetastaticnonsmallcelllungcancerretrospectiveanalysisoftwosingleinstitutionprospectivetrials AT barsoumianhampartsoum responseandoutcomesafterantictla4versusantipd1combinedwithstereotacticbodyradiationtherapyformetastaticnonsmallcelllungcancerretrospectiveanalysisoftwosingleinstitutionprospectivetrials AT younesahmed responseandoutcomesafterantictla4versusantipd1combinedwithstereotacticbodyradiationtherapyformetastaticnonsmallcelllungcancerretrospectiveanalysisoftwosingleinstitutionprospectivetrials AT huyun responseandoutcomesafterantictla4versusantipd1combinedwithstereotacticbodyradiationtherapyformetastaticnonsmallcelllungcancerretrospectiveanalysisoftwosingleinstitutionprospectivetrials AT wasleymark responseandoutcomesafterantictla4versusantipd1combinedwithstereotacticbodyradiationtherapyformetastaticnonsmallcelllungcancerretrospectiveanalysisoftwosingleinstitutionprospectivetrials AT cortezmariaangelica responseandoutcomesafterantictla4versusantipd1combinedwithstereotacticbodyradiationtherapyformetastaticnonsmallcelllungcancerretrospectiveanalysisoftwosingleinstitutionprospectivetrials AT welshjames responseandoutcomesafterantictla4versusantipd1combinedwithstereotacticbodyradiationtherapyformetastaticnonsmallcelllungcancerretrospectiveanalysisoftwosingleinstitutionprospectivetrials |