Immune Checkpoint Inhibitors effective for stage III-IV adenocarcinoma and squamous cell carcinoma

A recent study published in the journal BMC Cancer, 2022 said that Immune checkpoint inhibitors (ICIs) are not only effective in patients with Lung cancer but also improved objective response rate (ORR) and progression-free survival (PFS) significantly.

The malignant tumor with the highest mortality and morbidity throughout the world is Lung cancer. Immunotherapy has modified the treatment modality of many malignant tumors along with Lung carcinomas. So, researchers from China conducted a study to investigate the clinical application, efficacy, and safety of ICIs in the treatment of lung cancer in the real world. 

Researchers conducted a retrospective, observational analysis on ICI-treated patients from January 2015 to March 2021 in four tertiary hospitals. They evaluated the clinical efficacy of ICIs as single-agent or combined chemotherapy and anti-vascular drugs in the first-line or second-line treatment of patients with lung cancer. 

Results: 

• 315 patients enrolled in the study. 
• In patients with stage III-IV adenocarcinoma and Squamous cell carcinoma, the objective response rate (ORR) and disease control rate (DCR) were 35.5% and 93.5%, respectively. 
• The median progression-free survival (PFS) was 10.8 months, and the median overall survival (OS) was not reached. 

Efficacy: 

• 132 patients received ICIs as the first-line treatment; in them, the median treatment cycle was 8 cycles, the short-term efficacy ORR was 38.6%, DCR was 93.9%, and the median PFS was 11.4 months. 
• 113 patients received ICIs treatment as second-line treatment, the median treatment cycle was 5 cycles, the short-term efficacy ORR was 31.9%, DCR was 92.9%, and the median PFS was 10.0 months. 
• No statistically significant differences in ORR, DCR, or median PFS with ICIs as the first-line treatment compared with the second-line treatment were observed.  
• In the subgroup analysis, Eastern Cooperative Oncology Group performance status (ECOG PS), epidermal growth factor receptor (EGFR) mutation status, pathological type, and several treatment lines were not correlated with median PFS. 
• Statistically significant differences in programmed death-ligand 1(PD-L1) expression, corticosteroid interference, and antibiotic (Abx) treatment among all groups were seen. 

Safety: 

• The overall incidence of adverse reactions in 315 patients was 62.5%, and the incidence of immune-related adverse events (irAEs) was 13.7% in terms of safety. 
• Grade 1–2 and 3–4 incidence of adverse events were 34.9 and 27.65%, respectively. 
• 4 patients had fatal irAEs, 2 had liver damage leading to liver failure, 1 had immune-related pneumonia, and 1 had immune-related myocarditis. 

Thus, researchers concluded that ICIs are effective in patients with lung cancer and significantly improve ORR and PFS. 

To read the full article: https://doi.org/10.1186/s12885-022-09843-3 

Sun, M., Ji, H., Xu, N. et al. Real-world data analysis of immune checkpoint inhibitors in stage III-IV adenocarcinoma and squamous cell carcinoma. BMC Cancer 22, 762 (2022).