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Transl Lung Cancer Res: The efficacy of pembrolizumab (pembrolizumab) alone or in combination in the treatment of patients with advanced non-small cell lung cancer with bone metastases

 Last Update: 2022-03-04
 Source: Internet
 Author: User

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The incidence of bone metastases in patients with non-small cell lung cancer (NSCLC) is approximately 30-40% , and bone-related events seriously affect the quality of life
.

Immune checkpoint inhibitor (ICI) therapy has become the standard of care for patients with advanced NSCLC

The incidence of bone metastases in patients with non-small cell lung cancer (NSCLC) is approximately 30-40% , and bone-related events seriously affect the quality of life

In this retrospective study, a total of 110 patients with advanced NSCLC with bone metastases who received pembrolizumab (pembrolizumab) were included
.

Men accounted for 76.

In this retrospective study, a total of 110 patients with advanced NSCLC with bone metastases who received pembrolizumab (pembrolizumab) were included

Among them, 94.

In terms of efficacy, the ORR of the total population was 29.

Patients receiving first-line pembrolizumab had higher ORR (41.
4% vs.
15.
4%, P=0.
011), longer PFS (9.
0 vs.
4.
0 months, P=0.
004), and OS compared with second-line or higher therapy [Not Reached (NR) vs.
11.
5 months, P<0.
0001]
.

Patients receiving first-line pembrolizumab had higher ORR (41.

Patients with only 1 bone metastases had significantly longer OS than those with ≥2 bone metastases (PFS: 9.
0 vs.
4.
8 months, P=0.
070; OS: NR vs NR, P=0.
045)
.

Patients with only 1 bone metastases had significantly longer OS than those with ≥2 bone metastases (PFS: 9.

There was no statistically significant difference in PFS between patients with EGFR mutation-negative and positive tumors (PFS: 7.
5 months vs.
7.
0 months, P=0.
706; OS: NR vs.
12.
0 months, P=0.
247)
.

There was no statistically significant difference in PFS between patients with EGFR mutation-negative and positive tumors (PFS: 7.

Anti-bone therapy, including palliative bone radiotherapy and bone-targeted therapy, improved ORR (34.
9% vs.
11.
1%, P<0.
0001) and prolonged PFS (8.
5 vs.
2.
0 months, P=0.
002)
.

Anti-bone therapy, including palliative bone radiotherapy and bone-targeted therapy, improved ORR (34.

ECOG 0-1 score [OS: hazard ratio (HR) =0.
117, P<0.
0001] and first-line pembrolizumab treatment (OS: HR =0.
372, P=0.
004) were independent predictors of OS
.

ECOG 0-1 score [OS: hazard ratio (HR) =0.
117, P<0.
0001] and first-line pembrolizumab treatment (OS: HR =0.
372, P=0.
004) were independent predictors of OS
.
ECOG 0-1 score [OS: hazard ratio (HR) =0.
117, P<0.
0001] and first-line pembrolizumab treatment (OS: HR =0.
372, P=0.
004) were independent predictors of OS
.

Correlations of baseline serum lactate dehydrogenase (LDH), NLR and OS were assessed
.
OS was negatively correlated with baseline serum LDH and NLR levels (LDH: r=0.
345, P<0.
0001; NLR: r=0.
220, P=0.
021)
.
The optimal cut-off values for LDH and NLR in serum were 240.
5 IU/L and 5.
55, respectively
.
Survival analysis showed that compared with patients with high baseline LDH or NLR levels, baseline levels ≦240.
5 IU/L (NR vs.
10.
0 months, P<0.
000) or NLR ≦5.
55 (NR vs.
18.
0 months, P=0.
039) The patient's OS was significantly prolonged
.
Correlations of baseline serum lactate dehydrogenase (LDH), NLR and OS were assessed
.
OS was negatively correlated with baseline serum LDH and NLR levels (LDH: r=0.
345, P<0.
0001; NLR: r=0.
220, P=0.
021)
.
The optimal cut-off values for LDH and NLR in serum were 240.
5 IU/L and 5.
55, respectively
.
Survival analysis showed that compared with patients with high baseline LDH or NLR levels, baseline levels ≦240.
5 IU/L (NR vs.
10.
0 months, P<0.
000) or NLR ≦5.
55 (NR vs.
18.
0 months, P=0.
039) The patient's OS was significantly prolonged
.

In conclusion, the study demonstrated that the efficacy of pembrolizumab was confirmed in patients with advanced NSCLC with bone metastases, especially when undergoing palliative bone radiotherapy or bone-targeted therapy
.
Serum LDH baseline level ≤ 240.
5 IU/L, NLR ≤ 5.
55 can predict the prognosis of patients with advanced NSCLC with bone metastases after immunotherapy
.
Studies have shown that pembrolizumab has demonstrated efficacy in advanced NSCLC patients with bone metastases, especially when undergoing palliative bone radiotherapy or bone-targeted therapy
.
Serum LDH baseline level ≤ 240.
5 IU/L, NLR ≤ 5.
55 can predict the prognosis of patients with advanced NSCLC with bone metastases after immunotherapy
.
Studies have shown that pembrolizumab has demonstrated efficacy in advanced NSCLC patients with bone metastases, especially when undergoing palliative bone radiotherapy or bone-targeted therapy
.
Serum LDH baseline level ≤ 240.
5 IU/L, NLR ≤ 5.
55 can predict the prognosis of patients with advanced NSCLC with bone metastases after immunotherapy
.

Original source:

Qiang H, Lei Y, Shen Y, Li J, Zhong H, Zhong R, Zhang X, Chang Q, Lu J, Feng H, Zhu Y, Addeo A, Banna GL, Oh IJ, Qian J, Chu T.
Pembrolizumab monotherapy or combination therapy for bone metastases in advanced non- small cell lung cancer: a real-world retrospective study.
Transl Lung Cancer Res 2022;11(1):87-99.
doi: 10.
21037/tlcr-21-1033.

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