Comparison of treatment outcome between first‐line combination immunotherapy (anti‐PD‐L1 or anti‐PD1) with or without chemotherapy and chemotherapy alone in advanced non‐small cell lung cancer patients in tertiary care hospital

Abstract Background Despite promising outcomes of first‐line immunotherapy with or without chemotherapy in advanced non‐small cell lung cancer (NSCLC), limited accessibility due to reimbursement was remain the problem in low to middle income countries. This study aimed to evaluate real‐world effecti...

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Main Authors: Danainut Naratornsirakul, Busyamas Chewaskulyong, Sarawut Kongkarnka, Songporn Oranratnachai
Format: Article
Language:English
Published: Wiley 2024-07-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.70007
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author Danainut Naratornsirakul
Busyamas Chewaskulyong
Sarawut Kongkarnka
Songporn Oranratnachai
author_facet Danainut Naratornsirakul
Busyamas Chewaskulyong
Sarawut Kongkarnka
Songporn Oranratnachai
author_sort Danainut Naratornsirakul
collection DOAJ
description Abstract Background Despite promising outcomes of first‐line immunotherapy with or without chemotherapy in advanced non‐small cell lung cancer (NSCLC), limited accessibility due to reimbursement was remain the problem in low to middle income countries. This study aimed to evaluate real‐world effectiveness of immunotherapy in patients with advanced NSCLC in Northern Thailand. Method A retrospective, single‐centered cohort, was conducted. Patients with advanced NSCLC who underwent PD‐L1 testing (excluding EGFR and ALK mutations) and were treated with immunotherapy or without chemotherapy or chemotherapy alone were included. The primary end point was progression‐free survival (PFS). The secondary endpoints were overall survival (OS), objective response rate (ORR), and adverse events. Results A total of 123 patients, of which 21 patients received immunotherapy‐based regimen and 102 patients received chemotherapy alone. The median PFS was 11.9 months in immunotherapy‐based group compared to 5.93 months in the chemotherapy group, with a. hazard ratio (HR) of 0.4 (95% confidence interval [CI], 0.23 to 0.68; p = 0.001). Similarly, the median OS was 26.68 months in the immunotherapy‐based group and 11.21 months in the chemotherapy group, with HR of 0.42 (95% CI 0.22–0.8; p = 0.009). ORRs were significantly higher in the immunotherapy‐based group, with 65% of patients showing a response compared to 32% in the chemotherapy group (p = 0.006). Conclusion The result of this real‐world study in patients with advanced stage NSCLC indicate that first‐line immunotherapy‐based regimen was associated with significantly greater PFS, OS, and ORR with a safety profile consistent with pivotal studies.
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spelling doaj-art-337ba4840b5643c3918df86bccec7a7c2025-08-20T02:52:17ZengWileyCancer Medicine2045-76342024-07-011314n/an/a10.1002/cam4.70007Comparison of treatment outcome between first‐line combination immunotherapy (anti‐PD‐L1 or anti‐PD1) with or without chemotherapy and chemotherapy alone in advanced non‐small cell lung cancer patients in tertiary care hospitalDanainut Naratornsirakul0Busyamas Chewaskulyong1Sarawut Kongkarnka2Songporn Oranratnachai3Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine Chiang Mai University Chiang Mai ThailandDivision of Medical Oncology, Department of Internal Medicine, Faculty of Medicine Chiang Mai University Chiang Mai ThailandDepartment of Pathology, Faculty of Medicine Chiang Mai University Chiang Mai ThailandSriphat Medical Center, Faculty of Medicine Chiang Mai University Chiang Mai ThailandAbstract Background Despite promising outcomes of first‐line immunotherapy with or without chemotherapy in advanced non‐small cell lung cancer (NSCLC), limited accessibility due to reimbursement was remain the problem in low to middle income countries. This study aimed to evaluate real‐world effectiveness of immunotherapy in patients with advanced NSCLC in Northern Thailand. Method A retrospective, single‐centered cohort, was conducted. Patients with advanced NSCLC who underwent PD‐L1 testing (excluding EGFR and ALK mutations) and were treated with immunotherapy or without chemotherapy or chemotherapy alone were included. The primary end point was progression‐free survival (PFS). The secondary endpoints were overall survival (OS), objective response rate (ORR), and adverse events. Results A total of 123 patients, of which 21 patients received immunotherapy‐based regimen and 102 patients received chemotherapy alone. The median PFS was 11.9 months in immunotherapy‐based group compared to 5.93 months in the chemotherapy group, with a. hazard ratio (HR) of 0.4 (95% confidence interval [CI], 0.23 to 0.68; p = 0.001). Similarly, the median OS was 26.68 months in the immunotherapy‐based group and 11.21 months in the chemotherapy group, with HR of 0.42 (95% CI 0.22–0.8; p = 0.009). ORRs were significantly higher in the immunotherapy‐based group, with 65% of patients showing a response compared to 32% in the chemotherapy group (p = 0.006). Conclusion The result of this real‐world study in patients with advanced stage NSCLC indicate that first‐line immunotherapy‐based regimen was associated with significantly greater PFS, OS, and ORR with a safety profile consistent with pivotal studies.https://doi.org/10.1002/cam4.70007anti‐Pd1 immunotherapyanti‐PD‐L1immunotherapynon‐small cell lung cancer
spellingShingle Danainut Naratornsirakul
Busyamas Chewaskulyong
Sarawut Kongkarnka
Songporn Oranratnachai
Comparison of treatment outcome between first‐line combination immunotherapy (anti‐PD‐L1 or anti‐PD1) with or without chemotherapy and chemotherapy alone in advanced non‐small cell lung cancer patients in tertiary care hospital
Cancer Medicine
anti‐Pd1 immunotherapy
anti‐PD‐L1
immunotherapy
non‐small cell lung cancer
title Comparison of treatment outcome between first‐line combination immunotherapy (anti‐PD‐L1 or anti‐PD1) with or without chemotherapy and chemotherapy alone in advanced non‐small cell lung cancer patients in tertiary care hospital
title_full Comparison of treatment outcome between first‐line combination immunotherapy (anti‐PD‐L1 or anti‐PD1) with or without chemotherapy and chemotherapy alone in advanced non‐small cell lung cancer patients in tertiary care hospital
title_fullStr Comparison of treatment outcome between first‐line combination immunotherapy (anti‐PD‐L1 or anti‐PD1) with or without chemotherapy and chemotherapy alone in advanced non‐small cell lung cancer patients in tertiary care hospital
title_full_unstemmed Comparison of treatment outcome between first‐line combination immunotherapy (anti‐PD‐L1 or anti‐PD1) with or without chemotherapy and chemotherapy alone in advanced non‐small cell lung cancer patients in tertiary care hospital
title_short Comparison of treatment outcome between first‐line combination immunotherapy (anti‐PD‐L1 or anti‐PD1) with or without chemotherapy and chemotherapy alone in advanced non‐small cell lung cancer patients in tertiary care hospital
title_sort comparison of treatment outcome between first line combination immunotherapy anti pd l1 or anti pd1 with or without chemotherapy and chemotherapy alone in advanced non small cell lung cancer patients in tertiary care hospital
topic anti‐Pd1 immunotherapy
anti‐PD‐L1
immunotherapy
non‐small cell lung cancer
url https://doi.org/10.1002/cam4.70007
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