Efficacy of radiotherapy combined with atezolizumab or docetaxel in patients with previously treated NSCLC

Summary: Radiotherapy showed synergy with immunotherapy, yet the comparative effectiveness of combining immunotherapy (iRT) or chemotherapy (CRT) after platinum therapy failure in advanced non-small cell lung cancer (NSCLC) remains unexplored. We analyzed 163 patients (iRT: n = 120 vs. CRT: n = 43)...

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Main Authors: Junzhu Xu, Haitao Wang, Chi Zhang, Su-Han Jin, Xiaofei Chen, Fangya Tan, Benjamin Frey, Markus Hecht, Jian-Guo Sun, Udo S. Gaipl, Hu Ma, Jian-Guo Zhou
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:iScience
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589004224025884
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author Junzhu Xu
Haitao Wang
Chi Zhang
Su-Han Jin
Xiaofei Chen
Fangya Tan
Benjamin Frey
Markus Hecht
Jian-Guo Sun
Udo S. Gaipl
Hu Ma
Jian-Guo Zhou
author_facet Junzhu Xu
Haitao Wang
Chi Zhang
Su-Han Jin
Xiaofei Chen
Fangya Tan
Benjamin Frey
Markus Hecht
Jian-Guo Sun
Udo S. Gaipl
Hu Ma
Jian-Guo Zhou
author_sort Junzhu Xu
collection DOAJ
description Summary: Radiotherapy showed synergy with immunotherapy, yet the comparative effectiveness of combining immunotherapy (iRT) or chemotherapy (CRT) after platinum therapy failure in advanced non-small cell lung cancer (NSCLC) remains unexplored. We analyzed 163 patients (iRT: n = 120 vs. CRT: n = 43) eligible for combination radiotherapy. Before matching, median overall survival (OS) was significantly longer in iRT group (7.79 vs. 4.57 months, hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.41–0.94, p = 0.024). After 1:2 propensity score matching (PSM) and inverse probability of treatment weighting (IPTW), iRT group showed improved OS, consistent with unmatched analysis (PSM, p = 0.033 and IPTW, p = 0.035). Exploratory analysis suggested that PD1+, central memory PD1+, and effector memory PD-L1+ CD4+ T cells were strong predictive biomarkers for iRT-treated patients (POS = 0.025, POS = 0.002, POS = 0.010, respectively). Proliferative CD4+ T celllow was a prognostic (POS = 0.008) and predictive biomarker for iRT (POS < 0.001). Our work revealed iRT was prolonged OS in previously treated advanced NSCLC patients. Additionally, proliferative CD4+ T cell served as prognostic and predictive biomarkers.
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spelling doaj-art-95ecf10fc2194089b5dd577c07ec86a02025-08-20T02:35:03ZengElsevieriScience2589-00422024-12-01271211136310.1016/j.isci.2024.111363Efficacy of radiotherapy combined with atezolizumab or docetaxel in patients with previously treated NSCLCJunzhu Xu0Haitao Wang1Chi Zhang2Su-Han Jin3Xiaofei Chen4Fangya Tan5Benjamin Frey6Markus Hecht7Jian-Guo Sun8Udo S. Gaipl9Hu Ma10Jian-Guo Zhou11Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, P.R. ChinaThoracic Surgery Branch, Center for Cancer Research, NCI, NIH, Bethesda, MD 20892, USADepartment of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, P.R. ChinaDepartment of Orthodontics, Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, ChinaOncology Biometrics, AstraZeneca, Gaithersburg, MD 20850, USAHarrisburg University of Science and Technology, Harrisburg, PA 17101, USATranslational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; FAU Profile Center Immunomedicine (FAU I-MED), Friedrich-Alexander- Universität Erlangen-Nurnberg, Erlangen, GermanyDepartment of Radiotherapy and Radiation Oncology, Saarland University Medical Center, Homburg, GermanyCancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, ChinaTranslational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; FAU Profile Center Immunomedicine (FAU I-MED), Friedrich-Alexander- Universität Erlangen-Nurnberg, Erlangen, Germany; Corresponding authorDepartment of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, P.R. China; Corresponding authorDepartment of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, P.R. China; Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; FAU Profile Center Immunomedicine (FAU I-MED), Friedrich-Alexander- Universität Erlangen-Nurnberg, Erlangen, Germany; Corresponding authorSummary: Radiotherapy showed synergy with immunotherapy, yet the comparative effectiveness of combining immunotherapy (iRT) or chemotherapy (CRT) after platinum therapy failure in advanced non-small cell lung cancer (NSCLC) remains unexplored. We analyzed 163 patients (iRT: n = 120 vs. CRT: n = 43) eligible for combination radiotherapy. Before matching, median overall survival (OS) was significantly longer in iRT group (7.79 vs. 4.57 months, hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.41–0.94, p = 0.024). After 1:2 propensity score matching (PSM) and inverse probability of treatment weighting (IPTW), iRT group showed improved OS, consistent with unmatched analysis (PSM, p = 0.033 and IPTW, p = 0.035). Exploratory analysis suggested that PD1+, central memory PD1+, and effector memory PD-L1+ CD4+ T cells were strong predictive biomarkers for iRT-treated patients (POS = 0.025, POS = 0.002, POS = 0.010, respectively). Proliferative CD4+ T celllow was a prognostic (POS = 0.008) and predictive biomarker for iRT (POS < 0.001). Our work revealed iRT was prolonged OS in previously treated advanced NSCLC patients. Additionally, proliferative CD4+ T cell served as prognostic and predictive biomarkers.http://www.sciencedirect.com/science/article/pii/S2589004224025884Public healthCancer
spellingShingle Junzhu Xu
Haitao Wang
Chi Zhang
Su-Han Jin
Xiaofei Chen
Fangya Tan
Benjamin Frey
Markus Hecht
Jian-Guo Sun
Udo S. Gaipl
Hu Ma
Jian-Guo Zhou
Efficacy of radiotherapy combined with atezolizumab or docetaxel in patients with previously treated NSCLC
iScience
Public health
Cancer
title Efficacy of radiotherapy combined with atezolizumab or docetaxel in patients with previously treated NSCLC
title_full Efficacy of radiotherapy combined with atezolizumab or docetaxel in patients with previously treated NSCLC
title_fullStr Efficacy of radiotherapy combined with atezolizumab or docetaxel in patients with previously treated NSCLC
title_full_unstemmed Efficacy of radiotherapy combined with atezolizumab or docetaxel in patients with previously treated NSCLC
title_short Efficacy of radiotherapy combined with atezolizumab or docetaxel in patients with previously treated NSCLC
title_sort efficacy of radiotherapy combined with atezolizumab or docetaxel in patients with previously treated nsclc
topic Public health
Cancer
url http://www.sciencedirect.com/science/article/pii/S2589004224025884
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