PD‐1/PD‐L1 Inhibitors Plus Chemotherapy Versus Chemotherapy Alone as First‐Line Therapy for Patients With Unfavorable Cancer of Unknown Primary: A Multicenter, Retrospective Cohort Study

ABSTRACT This multicenter study aimed to investigate the efficacy and safety of PD‐1/PD‐L1 inhibitors plus chemotherapy (ICI‐Chemo group) versus chemotherapy alone (Chemo group) for patients with cancer of unknown primary (CUP) in the first‐line setting. We included patients with unfavorable CUP acr...

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Main Authors: Riqing Huang, Haifeng Li, Shuo Li, Ditian Shu, Rishang Chen, Zhousan Zheng, Tinghua Gao, Meiting Chen, Anqi Hu, Yunjie Huang, Qiufan Zheng, Xin An, Cong Xue, Yuchen Cai, Yanxia Shi
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Language:English
Published: Wiley 2025-03-01
Series:MedComm
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Online Access:https://doi.org/10.1002/mco2.70124
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author Riqing Huang
Haifeng Li
Shuo Li
Ditian Shu
Rishang Chen
Zhousan Zheng
Tinghua Gao
Meiting Chen
Anqi Hu
Yunjie Huang
Qiufan Zheng
Xin An
Cong Xue
Yuchen Cai
Yanxia Shi
author_facet Riqing Huang
Haifeng Li
Shuo Li
Ditian Shu
Rishang Chen
Zhousan Zheng
Tinghua Gao
Meiting Chen
Anqi Hu
Yunjie Huang
Qiufan Zheng
Xin An
Cong Xue
Yuchen Cai
Yanxia Shi
author_sort Riqing Huang
collection DOAJ
description ABSTRACT This multicenter study aimed to investigate the efficacy and safety of PD‐1/PD‐L1 inhibitors plus chemotherapy (ICI‐Chemo group) versus chemotherapy alone (Chemo group) for patients with cancer of unknown primary (CUP) in the first‐line setting. We included patients with unfavorable CUP across four medical centers in China. Between January 2014 and December 2023, 117 patients were enrolled: 46 patients in the ICI‐Chemo group and 71 patients in the Chemo group. After a median follow‐up of 28.1 months, the ICI‐Chemo group exhibited a significant improvement over the Chemo group in median PFS (9.10 months vs. 6.37 months; hazard ratio [HR] 0.46; 95% CI: 0.30–0.71; p < 0.001) and OS (35.67 months vs. 10.2 months; HR 0.37; 95% CI: 0.22–0.64; p < 0.001). Similarly, among patients who received TP (taxane plus platinum)‐based chemotherapies, OS and PFS benefits were observed in the ICI‐Chemo group. The objective response rate was higher in the ICI‐Chemo group than in the Chemo group (54.35% vs. 22.53%, p < 0.001). Grade 3 or higher drug‐related adverse events occurred in 11 patients (23.91%) in the ICI‐Chemo group and 28 patients (39.44%) in the Chemo group. Thus, PD‐1/PD‐L1 inhibitors plus chemotherapy could be the preferred first‐line treatment for patients with unfavorable CUP, providing improved efficacy and manageable toxicity.
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spelling doaj-art-7fe5b5a62a4f4a47a7fac6328772d0c82025-08-20T03:40:28ZengWileyMedComm2688-26632025-03-0163n/an/a10.1002/mco2.70124PD‐1/PD‐L1 Inhibitors Plus Chemotherapy Versus Chemotherapy Alone as First‐Line Therapy for Patients With Unfavorable Cancer of Unknown Primary: A Multicenter, Retrospective Cohort StudyRiqing Huang0Haifeng Li1Shuo Li2Ditian Shu3Rishang Chen4Zhousan Zheng5Tinghua Gao6Meiting Chen7Anqi Hu8Yunjie Huang9Qiufan Zheng10Xin An11Cong Xue12Yuchen Cai13Yanxia Shi14State Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaState Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaState Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaState Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaMedical Oncology Department III Central Hospital of Guangdong Nongken Zhanjiang P. R. ChinaDepartment of Oncology The First Affiliated Hospital of Sun Yat‐sen University Guangzhou P. R. ChinaDepartment of Oncology The First People's Hospital of Zhaoqing City Zhaoqing P. R. ChinaState Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaState Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaState Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaState Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaState Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaState Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaState Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaState Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaABSTRACT This multicenter study aimed to investigate the efficacy and safety of PD‐1/PD‐L1 inhibitors plus chemotherapy (ICI‐Chemo group) versus chemotherapy alone (Chemo group) for patients with cancer of unknown primary (CUP) in the first‐line setting. We included patients with unfavorable CUP across four medical centers in China. Between January 2014 and December 2023, 117 patients were enrolled: 46 patients in the ICI‐Chemo group and 71 patients in the Chemo group. After a median follow‐up of 28.1 months, the ICI‐Chemo group exhibited a significant improvement over the Chemo group in median PFS (9.10 months vs. 6.37 months; hazard ratio [HR] 0.46; 95% CI: 0.30–0.71; p < 0.001) and OS (35.67 months vs. 10.2 months; HR 0.37; 95% CI: 0.22–0.64; p < 0.001). Similarly, among patients who received TP (taxane plus platinum)‐based chemotherapies, OS and PFS benefits were observed in the ICI‐Chemo group. The objective response rate was higher in the ICI‐Chemo group than in the Chemo group (54.35% vs. 22.53%, p < 0.001). Grade 3 or higher drug‐related adverse events occurred in 11 patients (23.91%) in the ICI‐Chemo group and 28 patients (39.44%) in the Chemo group. Thus, PD‐1/PD‐L1 inhibitors plus chemotherapy could be the preferred first‐line treatment for patients with unfavorable CUP, providing improved efficacy and manageable toxicity.https://doi.org/10.1002/mco2.70124cancer of unknown primarychemotherapyfirst‐line therapyoverall survivalPD‐1/PD‐L1 inhibitors
spellingShingle Riqing Huang
Haifeng Li
Shuo Li
Ditian Shu
Rishang Chen
Zhousan Zheng
Tinghua Gao
Meiting Chen
Anqi Hu
Yunjie Huang
Qiufan Zheng
Xin An
Cong Xue
Yuchen Cai
Yanxia Shi
PD‐1/PD‐L1 Inhibitors Plus Chemotherapy Versus Chemotherapy Alone as First‐Line Therapy for Patients With Unfavorable Cancer of Unknown Primary: A Multicenter, Retrospective Cohort Study
MedComm
cancer of unknown primary
chemotherapy
first‐line therapy
overall survival
PD‐1/PD‐L1 inhibitors
title PD‐1/PD‐L1 Inhibitors Plus Chemotherapy Versus Chemotherapy Alone as First‐Line Therapy for Patients With Unfavorable Cancer of Unknown Primary: A Multicenter, Retrospective Cohort Study
title_full PD‐1/PD‐L1 Inhibitors Plus Chemotherapy Versus Chemotherapy Alone as First‐Line Therapy for Patients With Unfavorable Cancer of Unknown Primary: A Multicenter, Retrospective Cohort Study
title_fullStr PD‐1/PD‐L1 Inhibitors Plus Chemotherapy Versus Chemotherapy Alone as First‐Line Therapy for Patients With Unfavorable Cancer of Unknown Primary: A Multicenter, Retrospective Cohort Study
title_full_unstemmed PD‐1/PD‐L1 Inhibitors Plus Chemotherapy Versus Chemotherapy Alone as First‐Line Therapy for Patients With Unfavorable Cancer of Unknown Primary: A Multicenter, Retrospective Cohort Study
title_short PD‐1/PD‐L1 Inhibitors Plus Chemotherapy Versus Chemotherapy Alone as First‐Line Therapy for Patients With Unfavorable Cancer of Unknown Primary: A Multicenter, Retrospective Cohort Study
title_sort pd 1 pd l1 inhibitors plus chemotherapy versus chemotherapy alone as first line therapy for patients with unfavorable cancer of unknown primary a multicenter retrospective cohort study
topic cancer of unknown primary
chemotherapy
first‐line therapy
overall survival
PD‐1/PD‐L1 inhibitors
url https://doi.org/10.1002/mco2.70124
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