Helga H Hektoen, Kaitlyn M Tsuruda, Lars Fjellbirkeland, Yngvar Nilssen, Odd Terje Brustugun, Bettina K Andreassen
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引用次数: 0
摘要
背景：基于临床试验的良好结果，免疫检查点抑制剂（ICI）已成为无靶向突变的晚期非小细胞肺癌（NSCLC）的标准一线（1 L）全身抗癌治疗（SACT）。我们评估了这些结果是否适用于日常临床实践，并将接受 ICI 治疗的患者的总生存期（OS）与接受化疗的历史患者队列和临床试验结果进行了比较：研究对象包括2012-21年间在挪威接受SACT治疗的所有晚期NSCLC患者。临床特征和治疗信息均来自挪威健康登记处：所有8416名接受SACT治疗的晚期NSCLC患者的生存率随着ICIs的逐步应用而增加。2017年后接受1 L pembrolizumab治疗的患者的中位OS（单药/联合治疗：13.8/12.8个月）优于2017年前接受化疗的患者（8.0个月）。尽管在临床实践中，接受pembrolizumab治疗的患者的中位OS低于临床试验（Keynote-024/189：26.3/22.0个月），但相对于化疗的生存获益是相似的：我们的全国性研究表明，与临床试验中观察到的传统化疗相比，pembrolizumab的生存获益程度相似，这也证实了pembrolizumab在常规临床实践中的有效性。
Real-world evidence for pembrolizumab in non-small cell lung cancer: a nationwide cohort study.
Background: Based on favourable results from clinical trials, immune checkpoint inhibitors (ICI) have become the standard first line (1 L) systemic anticancer treatment (SACT) for advanced stage non-small cell lung cancer (NSCLC) without targetable mutations. We evaluate whether these results are generalizable to everyday clinical practice and compare overall survival (OS) of patients treated with ICI to a historical cohort of patients treated with chemotherapy and results from clinical trials.
Methods: Our study comprised all advanced NSCLC patients initiating SACT in 2012-21 in Norway. Clinical characteristics and treatment information was retrieved from Norwegian Health Registries.
Results: Survival for all 8416 advanced NSCLC patients treated with SACT increased concurrently with the gradual implementation of ICIs. Median OS of patients treated with 1 L pembrolizumab after 2017 was better (mono-/combination therapy: 13.8/12.8 months) than for patients treated with chemotherapy before 2017 (8.0 months). Although median OS for patients treated with pembrolizumab was lower in clinical practice than clinical trials (Keynote-024/189: 26.3/22.0 months), the survival benefit relative to chemotherapy was similar.
Conclusion: Our nationwide study demonstrated a survival benefit over conventional chemotherapy of a similar magnitude as observed in clinical trials and confirms the effectiveness of pembrolizumab in routine clinical practice.
期刊介绍：
The British Journal of Cancer is one of the most-cited general cancer journals, publishing significant advances in translational and clinical cancer research.It also publishes high-quality reviews and thought-provoking comment on all aspects of cancer prevention,diagnosis and treatment.
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