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Oligoprogressive Non-Small-Cell Lung Cancer under Treatment with PD-(L)1 Inhibitors

Oligoprogression (OPD) of non-small-cell lung cancer (NSCLC) occurs in approximately half of patients under targeted compounds (TKI) and facilitates use of regional therapies that can prolong survival. In order to characterize OPD in immunotherapy (IO)-treated NSCLC, we analyzed the failure pattern...

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Autores principales: Rheinheimer, Stephan, Heussel, Claus-Peter, Mayer, Philipp, Gaissmaier, Lena, Bozorgmehr, Farastuk, Winter, Hauke, Herth, Felix J., Muley, Thomas, Liersch, Stephan, Bischoff, Helge, Kriegsmann, Mark, El Shafie, Rami A., Stenzinger, Albrecht, Thomas, Michael, Kauczor, Hans-Ulrich, Christopoulos, Petros
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226015/
https://www.ncbi.nlm.nih.gov/pubmed/32340408
http://dx.doi.org/10.3390/cancers12041046
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author Rheinheimer, Stephan
Heussel, Claus-Peter
Mayer, Philipp
Gaissmaier, Lena
Bozorgmehr, Farastuk
Winter, Hauke
Herth, Felix J.
Muley, Thomas
Liersch, Stephan
Bischoff, Helge
Kriegsmann, Mark
El Shafie, Rami A.
Stenzinger, Albrecht
Thomas, Michael
Kauczor, Hans-Ulrich
Christopoulos, Petros
author_facet Rheinheimer, Stephan
Heussel, Claus-Peter
Mayer, Philipp
Gaissmaier, Lena
Bozorgmehr, Farastuk
Winter, Hauke
Herth, Felix J.
Muley, Thomas
Liersch, Stephan
Bischoff, Helge
Kriegsmann, Mark
El Shafie, Rami A.
Stenzinger, Albrecht
Thomas, Michael
Kauczor, Hans-Ulrich
Christopoulos, Petros
author_sort Rheinheimer, Stephan
collection PubMed
description Oligoprogression (OPD) of non-small-cell lung cancer (NSCLC) occurs in approximately half of patients under targeted compounds (TKI) and facilitates use of regional therapies that can prolong survival. In order to characterize OPD in immunotherapy (IO)-treated NSCLC, we analyzed the failure pattern under PD-1/PD-L1 inhibitors (n = 297) or chemoimmunotherapy (n = 75). Under IO monotherapy, OPD was more frequent (20% vs. 10%, p < 0.05), occurred later (median 11 vs. 5 months, p < 0.01), affected fewer sites (mean 1.1 vs. 1.5, p < 0.05), and involved fewer lesions (1.4 vs. 2.3, p < 0.05) in the first compared to later lines. Lymph nodes (42%, mainly mediastinal) and the brain (39%) were mostly affected, followed by the lung (24%) and other organs. Compared to multifocal progression, OPD occurred later (11 vs. 4 months, p < 0.001) and was associated with longer survival (26 vs. 13 months, p < 0.001) and higher tumor PD-L1 expression (p < 0.001). Chemoimmunotherapy showed a similar incidence of OPD as IO monotherapy (13% vs. 11% at 2 years). Local treatments were applied regularly for brain but only in 50% for extracranial lesions. Thus, NSCLC oligoprogression is less common under IO than under TKI, but also favorable. Since its frequency drops later in the disease, regular restaging and multidisciplinary evaluation are essential in order to exploit the full therapeutic potential.
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spelling pubmed-72260152020-05-18 Oligoprogressive Non-Small-Cell Lung Cancer under Treatment with PD-(L)1 Inhibitors Rheinheimer, Stephan Heussel, Claus-Peter Mayer, Philipp Gaissmaier, Lena Bozorgmehr, Farastuk Winter, Hauke Herth, Felix J. Muley, Thomas Liersch, Stephan Bischoff, Helge Kriegsmann, Mark El Shafie, Rami A. Stenzinger, Albrecht Thomas, Michael Kauczor, Hans-Ulrich Christopoulos, Petros Cancers (Basel) Article Oligoprogression (OPD) of non-small-cell lung cancer (NSCLC) occurs in approximately half of patients under targeted compounds (TKI) and facilitates use of regional therapies that can prolong survival. In order to characterize OPD in immunotherapy (IO)-treated NSCLC, we analyzed the failure pattern under PD-1/PD-L1 inhibitors (n = 297) or chemoimmunotherapy (n = 75). Under IO monotherapy, OPD was more frequent (20% vs. 10%, p < 0.05), occurred later (median 11 vs. 5 months, p < 0.01), affected fewer sites (mean 1.1 vs. 1.5, p < 0.05), and involved fewer lesions (1.4 vs. 2.3, p < 0.05) in the first compared to later lines. Lymph nodes (42%, mainly mediastinal) and the brain (39%) were mostly affected, followed by the lung (24%) and other organs. Compared to multifocal progression, OPD occurred later (11 vs. 4 months, p < 0.001) and was associated with longer survival (26 vs. 13 months, p < 0.001) and higher tumor PD-L1 expression (p < 0.001). Chemoimmunotherapy showed a similar incidence of OPD as IO monotherapy (13% vs. 11% at 2 years). Local treatments were applied regularly for brain but only in 50% for extracranial lesions. Thus, NSCLC oligoprogression is less common under IO than under TKI, but also favorable. Since its frequency drops later in the disease, regular restaging and multidisciplinary evaluation are essential in order to exploit the full therapeutic potential. MDPI 2020-04-23 /pmc/articles/PMC7226015/ /pubmed/32340408 http://dx.doi.org/10.3390/cancers12041046 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rheinheimer, Stephan
Heussel, Claus-Peter
Mayer, Philipp
Gaissmaier, Lena
Bozorgmehr, Farastuk
Winter, Hauke
Herth, Felix J.
Muley, Thomas
Liersch, Stephan
Bischoff, Helge
Kriegsmann, Mark
El Shafie, Rami A.
Stenzinger, Albrecht
Thomas, Michael
Kauczor, Hans-Ulrich
Christopoulos, Petros
Oligoprogressive Non-Small-Cell Lung Cancer under Treatment with PD-(L)1 Inhibitors
title Oligoprogressive Non-Small-Cell Lung Cancer under Treatment with PD-(L)1 Inhibitors
title_full Oligoprogressive Non-Small-Cell Lung Cancer under Treatment with PD-(L)1 Inhibitors
title_fullStr Oligoprogressive Non-Small-Cell Lung Cancer under Treatment with PD-(L)1 Inhibitors
title_full_unstemmed Oligoprogressive Non-Small-Cell Lung Cancer under Treatment with PD-(L)1 Inhibitors
title_short Oligoprogressive Non-Small-Cell Lung Cancer under Treatment with PD-(L)1 Inhibitors
title_sort oligoprogressive non-small-cell lung cancer under treatment with pd-(l)1 inhibitors
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226015/
https://www.ncbi.nlm.nih.gov/pubmed/32340408
http://dx.doi.org/10.3390/cancers12041046
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