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PD-1/PD-L1 checkpoint inhibitors during late stages of life: an ad-hoc analysis from a large multicenter cohort

BACKGROUND: The favourable safety profile and the increasing confidence with immune checkpoint inhibitors (ICIs) might have boosted their prescription in frail patients with short life expectancies, who usually are not treated with standard chemotherapy. METHODS: The present analysis aims to describ...

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Autores principales: Santini, Daniele, Zeppola, Tea, Russano, Marco, Citarella, Fabrizio, Anesi, Cecilia, Buti, Sebastiano, Tucci, Marco, Russo, Alessandro, Sergi, Maria Chiara, Adamo, Vincenzo, Stucci, Luigia S., Bersanelli, Melissa, Mazzaschi, Giulia, Spagnolo, Francesco, Rastelli, Francesca, Giorgi, Francesca Chiara, Giusti, Raffaele, Filetti, Marco, Marchetti, Paolo, Botticelli, Andrea, Gelibter, Alain, Siringo, Marco, Ferrari, Marco, Marconcini, Riccardo, Vitale, Maria Giuseppa, Nicolardi, Linda, Chiari, Rita, Ghidini, Michele, Nigro, Olga, Grossi, Francesco, De Tursi, Michele, Di Marino, Pietro, Pala, Laura, Queirolo, Paola, Bracarda, Sergio, Macrini, Serena, Gori, Stefania, Inno, Alessandro, Zoratto, Federica, Tanda, Enrica T., Mallardo, Domenico, Vitale, Maria Grazia, Talbot, Thomas, Ascierto, Paolo A., Pinato, David J., Ficorella, Corrado, Porzio, Giampiero, Cortellini, Alessio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223272/
https://www.ncbi.nlm.nih.gov/pubmed/34167578
http://dx.doi.org/10.1186/s12967-021-02937-9
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author Santini, Daniele
Zeppola, Tea
Russano, Marco
Citarella, Fabrizio
Anesi, Cecilia
Buti, Sebastiano
Tucci, Marco
Russo, Alessandro
Sergi, Maria Chiara
Adamo, Vincenzo
Stucci, Luigia S.
Bersanelli, Melissa
Mazzaschi, Giulia
Spagnolo, Francesco
Rastelli, Francesca
Giorgi, Francesca Chiara
Giusti, Raffaele
Filetti, Marco
Marchetti, Paolo
Botticelli, Andrea
Gelibter, Alain
Siringo, Marco
Ferrari, Marco
Marconcini, Riccardo
Vitale, Maria Giuseppa
Nicolardi, Linda
Chiari, Rita
Ghidini, Michele
Nigro, Olga
Grossi, Francesco
De Tursi, Michele
Di Marino, Pietro
Pala, Laura
Queirolo, Paola
Bracarda, Sergio
Macrini, Serena
Gori, Stefania
Inno, Alessandro
Zoratto, Federica
Tanda, Enrica T.
Mallardo, Domenico
Vitale, Maria Grazia
Talbot, Thomas
Ascierto, Paolo A.
Pinato, David J.
Ficorella, Corrado
Porzio, Giampiero
Cortellini, Alessio
author_facet Santini, Daniele
Zeppola, Tea
Russano, Marco
Citarella, Fabrizio
Anesi, Cecilia
Buti, Sebastiano
Tucci, Marco
Russo, Alessandro
Sergi, Maria Chiara
Adamo, Vincenzo
Stucci, Luigia S.
Bersanelli, Melissa
Mazzaschi, Giulia
Spagnolo, Francesco
Rastelli, Francesca
Giorgi, Francesca Chiara
Giusti, Raffaele
Filetti, Marco
Marchetti, Paolo
Botticelli, Andrea
Gelibter, Alain
Siringo, Marco
Ferrari, Marco
Marconcini, Riccardo
Vitale, Maria Giuseppa
Nicolardi, Linda
Chiari, Rita
Ghidini, Michele
Nigro, Olga
Grossi, Francesco
De Tursi, Michele
Di Marino, Pietro
Pala, Laura
Queirolo, Paola
Bracarda, Sergio
Macrini, Serena
Gori, Stefania
Inno, Alessandro
Zoratto, Federica
Tanda, Enrica T.
Mallardo, Domenico
Vitale, Maria Grazia
Talbot, Thomas
Ascierto, Paolo A.
Pinato, David J.
Ficorella, Corrado
Porzio, Giampiero
Cortellini, Alessio
author_sort Santini, Daniele
collection PubMed
description BACKGROUND: The favourable safety profile and the increasing confidence with immune checkpoint inhibitors (ICIs) might have boosted their prescription in frail patients with short life expectancies, who usually are not treated with standard chemotherapy. METHODS: The present analysis aims to describe clinicians’ attitudes towards ICIs administration during late stages of life within a multicenter cohort of advanced cancer patients treated with single agent PD-1/PD-L1 checkpoint inhibitors in Italy. RESULTS: Overall, 1149 patients with advanced cancer who received single agent PD-1/PD-L1 checkpoint inhibitors were screened. The final study population consisted of 567 deceased patients. 166 patients (29.3%) had received ICIs within 30 days of death; among them there was a significantly higher proportion of patients with ECOG-PS ≥ 2 (28.3% vs 11.5%, p < 0.0001) and with a higher burden of disease (69.3% vs 59.4%, p = 0.0266). In total, 35 patients (6.2%) started ICIs within 30 days of death; among them there was a higher proportion of patients with ECOG-PS ≥ 2 (45.7% vs 14.5%, p < 0.0001) and with a higher burden of disease (82.9% vs 60.9%, p = 0.0266). Primary tumors were significantly different across subgroups (p = 0.0172), with a higher prevalence of NSCLC patients (80% vs 60.9%) among those who started ICIs within 30 days of death. Lastly, 123 patients (21.7%) started ICIs within 3 months of death. Similarly, within this subgroup there was a higher proportion of patients with ECOG-PS ≥ 2 (29.3% vs 12.8%, p < 0.0001), with a higher burden of disease (74.0% vs 59.0%, p = 0.0025) and with NSCLC (74.0% vs 58.8%, p = 0.0236). CONCLUSION: Our results confirmed a trend toward an increasing ICIs prescription in frail patients, during the late stages of life. Caution should be exercised when evaluating an ICI treatment for patients with a poor PS and a high burden of disease. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12967-021-02937-9.
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spelling pubmed-82232722021-06-24 PD-1/PD-L1 checkpoint inhibitors during late stages of life: an ad-hoc analysis from a large multicenter cohort Santini, Daniele Zeppola, Tea Russano, Marco Citarella, Fabrizio Anesi, Cecilia Buti, Sebastiano Tucci, Marco Russo, Alessandro Sergi, Maria Chiara Adamo, Vincenzo Stucci, Luigia S. Bersanelli, Melissa Mazzaschi, Giulia Spagnolo, Francesco Rastelli, Francesca Giorgi, Francesca Chiara Giusti, Raffaele Filetti, Marco Marchetti, Paolo Botticelli, Andrea Gelibter, Alain Siringo, Marco Ferrari, Marco Marconcini, Riccardo Vitale, Maria Giuseppa Nicolardi, Linda Chiari, Rita Ghidini, Michele Nigro, Olga Grossi, Francesco De Tursi, Michele Di Marino, Pietro Pala, Laura Queirolo, Paola Bracarda, Sergio Macrini, Serena Gori, Stefania Inno, Alessandro Zoratto, Federica Tanda, Enrica T. Mallardo, Domenico Vitale, Maria Grazia Talbot, Thomas Ascierto, Paolo A. Pinato, David J. Ficorella, Corrado Porzio, Giampiero Cortellini, Alessio J Transl Med Research BACKGROUND: The favourable safety profile and the increasing confidence with immune checkpoint inhibitors (ICIs) might have boosted their prescription in frail patients with short life expectancies, who usually are not treated with standard chemotherapy. METHODS: The present analysis aims to describe clinicians’ attitudes towards ICIs administration during late stages of life within a multicenter cohort of advanced cancer patients treated with single agent PD-1/PD-L1 checkpoint inhibitors in Italy. RESULTS: Overall, 1149 patients with advanced cancer who received single agent PD-1/PD-L1 checkpoint inhibitors were screened. The final study population consisted of 567 deceased patients. 166 patients (29.3%) had received ICIs within 30 days of death; among them there was a significantly higher proportion of patients with ECOG-PS ≥ 2 (28.3% vs 11.5%, p < 0.0001) and with a higher burden of disease (69.3% vs 59.4%, p = 0.0266). In total, 35 patients (6.2%) started ICIs within 30 days of death; among them there was a higher proportion of patients with ECOG-PS ≥ 2 (45.7% vs 14.5%, p < 0.0001) and with a higher burden of disease (82.9% vs 60.9%, p = 0.0266). Primary tumors were significantly different across subgroups (p = 0.0172), with a higher prevalence of NSCLC patients (80% vs 60.9%) among those who started ICIs within 30 days of death. Lastly, 123 patients (21.7%) started ICIs within 3 months of death. Similarly, within this subgroup there was a higher proportion of patients with ECOG-PS ≥ 2 (29.3% vs 12.8%, p < 0.0001), with a higher burden of disease (74.0% vs 59.0%, p = 0.0025) and with NSCLC (74.0% vs 58.8%, p = 0.0236). CONCLUSION: Our results confirmed a trend toward an increasing ICIs prescription in frail patients, during the late stages of life. Caution should be exercised when evaluating an ICI treatment for patients with a poor PS and a high burden of disease. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12967-021-02937-9. BioMed Central 2021-06-24 /pmc/articles/PMC8223272/ /pubmed/34167578 http://dx.doi.org/10.1186/s12967-021-02937-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Santini, Daniele
Zeppola, Tea
Russano, Marco
Citarella, Fabrizio
Anesi, Cecilia
Buti, Sebastiano
Tucci, Marco
Russo, Alessandro
Sergi, Maria Chiara
Adamo, Vincenzo
Stucci, Luigia S.
Bersanelli, Melissa
Mazzaschi, Giulia
Spagnolo, Francesco
Rastelli, Francesca
Giorgi, Francesca Chiara
Giusti, Raffaele
Filetti, Marco
Marchetti, Paolo
Botticelli, Andrea
Gelibter, Alain
Siringo, Marco
Ferrari, Marco
Marconcini, Riccardo
Vitale, Maria Giuseppa
Nicolardi, Linda
Chiari, Rita
Ghidini, Michele
Nigro, Olga
Grossi, Francesco
De Tursi, Michele
Di Marino, Pietro
Pala, Laura
Queirolo, Paola
Bracarda, Sergio
Macrini, Serena
Gori, Stefania
Inno, Alessandro
Zoratto, Federica
Tanda, Enrica T.
Mallardo, Domenico
Vitale, Maria Grazia
Talbot, Thomas
Ascierto, Paolo A.
Pinato, David J.
Ficorella, Corrado
Porzio, Giampiero
Cortellini, Alessio
PD-1/PD-L1 checkpoint inhibitors during late stages of life: an ad-hoc analysis from a large multicenter cohort
title PD-1/PD-L1 checkpoint inhibitors during late stages of life: an ad-hoc analysis from a large multicenter cohort
title_full PD-1/PD-L1 checkpoint inhibitors during late stages of life: an ad-hoc analysis from a large multicenter cohort
title_fullStr PD-1/PD-L1 checkpoint inhibitors during late stages of life: an ad-hoc analysis from a large multicenter cohort
title_full_unstemmed PD-1/PD-L1 checkpoint inhibitors during late stages of life: an ad-hoc analysis from a large multicenter cohort
title_short PD-1/PD-L1 checkpoint inhibitors during late stages of life: an ad-hoc analysis from a large multicenter cohort
title_sort pd-1/pd-l1 checkpoint inhibitors during late stages of life: an ad-hoc analysis from a large multicenter cohort
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223272/
https://www.ncbi.nlm.nih.gov/pubmed/34167578
http://dx.doi.org/10.1186/s12967-021-02937-9
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