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Current Oncology
Volume 27
Issue 2
10.3747/co.27.5495
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Treatment of Non-Small-Cell Lung Cancer after Progression on Nivolumab or Pembrolizumab

by
A.T. Freeman
1,*,
M. Lesperance
2,
E.S. Wai
1,3,
N.S. Croteau
2,
L. Fiorino
1,3,
G. Geller
1,3,
E.G. Brooks
1,3,
Z. Poonja
1,3,
D. Fenton
1,3,
S. Irons
2 and
D. Ksienski
1,3
1
BC Cancer–Victoria, Victoria, BC, Canada
2
University of Victoria, Department of Mathematics and Statistics, Victoria, BC, Canada
3
University of British Columbia, Department of Medicine, Vancouver, BC, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2020, 27(2), 76-82; https://doi.org/10.3747/co.27.5495
Submission received: 7 February 2020 / Revised: 6 March 2020 / Accepted: 5 April 2020 / Published: 1 May 2020

Abstract

Background: Although PD-1 antibodies (PD1 Ab) are the standard of care for advanced non-small-cell lung cancer (ansclc), most patients will progress. We compared survival outcomes for patients with ansclc who received systemic therapy (st) after progression and for those who did not. Additionally, clinical characteristics that predicted receipt of st after PD1 Ab failure were evaluated. Methods: All patients with ansclc in British Columbia initiated on nivolumab or pembrolizumab between June 2015 and November 2017, with subsequent progression, were identified. Eligibility criteria for additional st included an Eastern Cooperative Oncology Group (ecog) performance status (ps) of 3 or less and survival for more than 30 days from the last PD1 Ab treatment. Post-progression survival (pps) was assessed by landmark analysis. Baseline characteristics associated with pps were identified by multivariable analysis. Results: Of 94 patients meeting the eligibility criteria, 33 received st after progression. In 75.6%, a PD1 Ab was received as first- or second-line treatment. The most common sts were erlotinib (36.4%) and docetaxel (27.3%). No statistically significant difference in median pps was observed between patients who did and did not receive st within 30 days of their last PD1 Ab treatment (6.9 months vs. 3.6 months, log-rank p = 0.15.) In multivariable analysis, factors associated with increased pps included an ecog ps of 0 or 1 compared with 2 or 3 [hazard ratio (hr): 0.42; 95% confidence interval (ci): 0.24 to 0.73; p = 0.002] and any response compared with no response to PD1 Ab (hr: 0.54; 95% ci: 0.33 to 0.90; p = 0.02). Conclusions: In this cohort, only 35.1% of patients eligible for post–PD1 Ab therapy received st. Post-progression survival was not significantly affected by receipt of post-progression therapy. Prospective trials are needed to clarify the benefit of post–PD1 Ab treatments.
Keywords: pembrolizumab; nivolumab; non-small-cell lung cancer; immunotherapy; post-progression survival pembrolizumab; nivolumab; non-small-cell lung cancer; immunotherapy; post-progression survival

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MDPI and ACS Style

Freeman, A.T.; Lesperance, M.; Wai, E.S.; Croteau, N.S.; Fiorino, L.; Geller, G.; Brooks, E.G.; Poonja, Z.; Fenton, D.; Irons, S.; et al. Treatment of Non-Small-Cell Lung Cancer after Progression on Nivolumab or Pembrolizumab. Curr. Oncol. 2020, 27, 76-82. https://doi.org/10.3747/co.27.5495

AMA Style

Freeman AT, Lesperance M, Wai ES, Croteau NS, Fiorino L, Geller G, Brooks EG, Poonja Z, Fenton D, Irons S, et al. Treatment of Non-Small-Cell Lung Cancer after Progression on Nivolumab or Pembrolizumab. Current Oncology. 2020; 27(2):76-82. https://doi.org/10.3747/co.27.5495

Chicago/Turabian Style

Freeman, A.T., M. Lesperance, E.S. Wai, N.S. Croteau, L. Fiorino, G. Geller, E.G. Brooks, Z. Poonja, D. Fenton, S. Irons, and et al. 2020. "Treatment of Non-Small-Cell Lung Cancer after Progression on Nivolumab or Pembrolizumab" Current Oncology 27, no. 2: 76-82. https://doi.org/10.3747/co.27.5495

APA Style

Freeman, A. T., Lesperance, M., Wai, E. S., Croteau, N. S., Fiorino, L., Geller, G., Brooks, E. G., Poonja, Z., Fenton, D., Irons, S., & Ksienski, D. (2020). Treatment of Non-Small-Cell Lung Cancer after Progression on Nivolumab or Pembrolizumab. Current Oncology, 27(2), 76-82. https://doi.org/10.3747/co.27.5495

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