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Anti-Cancer Agents in Medicinal Chemistry

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ISSN (Print): 1871-5206
ISSN (Online): 1875-5992

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Research Article

Pembrolizumab for First-Line Treatment of Advanced Non-Small-Cell Lung Cancer: Analysis of Prognostic Factors of Outcomes

Author(s): Carmelo Tibaldi*, Francesca Mazzoni, Vieri Scotti, Enrico Vasile, Daniele Pozzessere, Irene Stasi, Andrea Camerini, Francesca Federici, Giulia Meoni, Chiara Caparello, Marianna Turrini, Virginia Rossi , Lucia Pia Ciccone, Irene Pecora, Beatrice Fantechi, Lorenzo Antonuzzo, Diana Giannarelli and Editta Baldini

Volume 22, Issue 7, 2022

Published on: 27 July, 2021

Page: [1278 - 1285] Pages: 8

DOI: 10.2174/1871520621666210727112212

Price: $65

Abstract

Background: In advanced non-small-cell lung cancer, without activating mutations and with PD-L1≥50%, Pembrolizumab monotherapy is the therapeutic standard in Europe.

Objective: To evaluate retrospectively the safety and efficacy of this drug and to investigate potential prognostic factors in daily clinical practice.

Methods: From September 2017 to September 2019, 205 consecutive patients from 14 Italian Medical Oncology Units were enrolled in the study. Gender, Age (> or <70 years), ECOG-PS (0-1 or 2), histology (squamous or nonsquamous), presence of brain, bone and liver metastases at baseline, PD-L1 score (>90% or <90%), smoking status (never or former or current) were applied to the stratified log-rank. Cox’s proportional hazards model was used for multivariate analysis.

Results: At a median follow-up of 15.2 months, median progression-free and overall survival (mPFS and mOS) were 9.2 months (95% C.I., 4.8-13.5) and 15.9 months (95% C.I., not yet evaluable), respectively. Patients with Eastern Cooperative Oncology Group performance status (ECOG-PS) 2 had mPFS of 2.8 months (95% C.I., 2.1-3.4) and mOS of 3.9 months (95% C.I., 2.5-5.3). Patients with liver metastases at diagnosis had an mPFS of 3.2 months (95% C.I., 0.6-5.8) and an mOS of 6.0 months (95% C.I., 3.7-8.4). At multivariate analysis for OS gender, ECOG-PS 2, and presence of liver metastases were independent prognostic factors.

Conclusion: Patients with ECOG-PS 2 derived little benefit from the use of first-line pembrolizumab. In patients with liver metastases, the association of pembrolizumab with platinum-based chemotherapy could be a better option than pembrolizumab alone.

Keywords: NSCLC, pembrolizumab, liver metastases, prognostic factors, platinum-based chemotherapy, PD-L1.

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