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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...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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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. |
format | Online Article Text |
id | pubmed-7226015 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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