Utility of atezolizumab plus bevacizumab, carboplatin, and paclitaxel combination for the treatment of advanced non-squamous non-small cell lung cancer patients with malignant pleural effusion.

IF 4 2区医学 Q2 ONCOLOGY Translational lung cancer research Pub Date : 2024-09-30 Epub Date: 2024-09-06 DOI:10.21037/tlcr-24-347

Kakeru Hisakane, Kenichiro Atsumi, Masahiro Seike, Takashi Hirose

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Abstract

Background: Malignant pleural effusion (MPE) remains a negative prognostic factor in non-small cell lung cancer (NSCLC), even after the emergence of immune checkpoint inhibitors. Vascular endothelial growth factor (VEGF) plays a pivotal role in the pathogenesis of MPE. Bevacizumab, a humanized monoclonal antibody against VEGF, is a key agent for patients who develop MPE. However, it is unclear whether MPE is a poor prognostic factor in patients with advanced non-squamous NSCLC receiving treatment with the atezolizumab plus bevacizumab, carboplatin, and paclitaxel (ABCP) regimen. Moreover, the effect of ABCP on MPE control is unknown. This study aimed to elucidate the efficacy and safety of ABCP for non-squamous NSCLC patients with MPE.

Methods: We retrospectively analyzed consecutive patients with advanced non-squamous NSCLC who received treatment with ABCP (January 2019-September 2023). Patients were divided into two groups (non-MPE and MPE), and treatment outcomes were compared. In the MPE group, treatment efficacy for MPE control and toxicity were evaluated.

Results: Of the 46 patients enrolled, 17 and 29 were included in the non-MPE and MPE groups, respectively. The objective response and disease control rates were not significantly different between the non-MPE and MPE groups (76.5% vs. 51.7%, P=0.13; 88.2% vs. 82.8%, P>0.99; respectively). Similarly, the median progression-free survival and median overall survival were not significantly different (9.9 vs. 10.1 months, P=0.87; 16.0 vs. 19.9 months, P=0.87, respectively). In the MPE group, 25 patients (86.2%) achieved MPE control lasting >8 weeks from the initiation of treatment with ABCP; the median progression-free survival without an unequivocal increase in MPE was 15.0 months. The incidence rates of grade ≥3 non-immune- and immune-related adverse events were 83% and 17%, respectively. There was no treatment-related death.

Conclusions: The ABCP regimen may be a promising treatment option for non-squamous NSCLC patients with MPE.

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阿特珠单抗联合贝伐单抗、卡铂和紫杉醇治疗晚期恶性胸腔积液非鳞状非小细胞肺癌患者的实用性。

背景：即使在免疫检查点抑制剂出现之后，恶性胸腔积液（MPE）仍然是非小细胞肺癌（NSCLC）的一个不良预后因素。血管内皮生长因子（VEGF）在MPE的发病机制中起着关键作用。贝伐单抗是一种针对血管内皮生长因子的人源化单克隆抗体，是治疗 MPE 患者的关键药物。然而，对于接受阿特珠单抗加贝伐单抗、卡铂和紫杉醇（ABCP）方案治疗的晚期非鳞癌 NSCLC 患者来说，MPE 是否是一个不良预后因素尚不清楚。此外，ABCP对MPE控制的影响尚不清楚。本研究旨在阐明ABCP对非鳞癌NSCLC MPE患者的疗效和安全性：我们回顾性分析了连续接受ABCP治疗的晚期非鳞NSCLC患者（2019年1月至2023年9月）。患者被分为两组（非MPE组和MPE组），并对治疗结果进行了比较。在 MPE 组中，对 MPE 控制的疗效和毒性进行了评估：结果：在入组的 46 名患者中，非 MPE 组和 MPE 组分别有 17 名和 29 名患者。非 MPE 组和 MPE 组的客观反应率和疾病控制率无明显差异（分别为 76.5% vs. 51.7%，P=0.13；88.2% vs. 82.8%，P>0.99；）。同样，中位无进展生存期和中位总生存期也无明显差异（分别为9.9个月对10.1个月，P=0.87；16.0个月对19.9个月，P=0.87）。在MPE组中，有25名患者（86.2%）在开始接受ABCP治疗后，MPE控制时间超过8周；在MPE没有明显增加的情况下，中位无进展生存期为15.0个月。非免疫和免疫相关的≥3级不良事件发生率分别为83%和17%。无治疗相关死亡病例：ABCP方案可能是治疗非鳞癌NSCLC MPE患者的一种很有前景的选择。

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来源期刊

Translational lung cancer research Medicine-Oncology

CiteScore

7.20

自引率

2.50%

发文量

137

期刊介绍： Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.