Efficacy of PD-1 blockade plus chemotherapy in patients with oncogenic-driven non-small-cell lung cancer
Abstract Background PD-1 blockade plus chemotherapy has become the first-line standard of care for patients with advanced non-small-cell lung cancer (NSCLC) without oncogenic drivers. Oncogenic-driven advanced NSCLC showed limited response to PD-1 blockade monotherapy or chemotherapy alone. Whether...
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Springer
2025-02-01
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| Series: | Cancer Immunology, Immunotherapy |
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| Online Access: | https://doi.org/10.1007/s00262-024-03937-6 |
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| author | Haowei Wang Lei Cheng Jian Chen Peixin Chen Zhuoran Tang Qianyi Wang Ying Ma Chao Zhao Xuefei Li Tao Jiang Fei Zhou Xiaoxia Chen Caicun Zhou |
| author_facet | Haowei Wang Lei Cheng Jian Chen Peixin Chen Zhuoran Tang Qianyi Wang Ying Ma Chao Zhao Xuefei Li Tao Jiang Fei Zhou Xiaoxia Chen Caicun Zhou |
| author_sort | Haowei Wang |
| collection | DOAJ |
| description | Abstract Background PD-1 blockade plus chemotherapy has become the first-line standard of care for patients with advanced non-small-cell lung cancer (NSCLC) without oncogenic drivers. Oncogenic-driven advanced NSCLC showed limited response to PD-1 blockade monotherapy or chemotherapy alone. Whether NSCLC patients with oncogenic drivers could benefit from PD-1 blockade plus chemotherapy remains undetermined. Methods Three hundred twelve NSCLC patients with at least one oncogenic driver alteration received PD-1 plus chemotherapy or each monotherapy were retrospectively identified. Objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were compared to evaluate the therapeutic outcomes differences among patients with different oncogenic drivers. Results One hundred sixty-two patients received PD-1 blockade plus chemotherapy, 57 received PD-1 blockade monotherapy and 93 received chemotherapy alone were included. Oncogenic driver mutations including KRAS (31.4%), EGFR (28.8%), HER2 (14.7%), BRAF (10.6%), RET (7.4%), and other mutations (7.1%) were identified. Patients with oncogenic drivers who received PD-1 blockade plus chemotherapy had significantly better outcomes compared to those received PD-1 blockade or chemotherapy alone (ORR: 51% vs. 18% vs. 25%, P < 0.001; median PFS: 10.0 [95% CI: 8.9–12.6] vs. 3.7 [95% CI: 2.9–5.1] vs. 5.3 [95% CI: 4.5–6.2] months, P < 0.001; median OS: 26.0 [95% CI: 23.0–30.0] vs. 14.3 [95% CI: 9.6–19.8] vs. 16.1 [95% CI: 11.6–21.9] months, P < 0.001). The superior efficacy was consistently found in separate analyses for patients received first-line and second/third line treatments. Among individual gene alterations, patients with KRAS, EGFR, or BRAF mutations treated with PD-1 blockade plus chemotherapy achieved markedly improved PFS and OS than those received PD-1 blockade or chemotherapy alone. Multivariate Cox regression analysis revealed that PD-1 blockade plus chemotherapy was independently associated with better PFS and OS. Conclusion PD-1 blockade plus chemotherapy demonstrated superior efficacy than PD-1 blockade monotherapy or chemotherapy alone in patients with oncogenic-driven advanced NSCLC, particularly in KRAS, EGFR and BRAF subgroups. These findings suggest that PD-1 blockade plus chemotherapy may be considered as an optional treatment option for patients without available targeted therapies. |
| format | Article |
| id | doaj-art-f0c8211bb30b488b974feaa4de57fa2a |
| institution | Kabale University |
| issn | 1432-0851 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Springer |
| record_format | Article |
| series | Cancer Immunology, Immunotherapy |
| spelling | doaj-art-f0c8211bb30b488b974feaa4de57fa2a2025-02-02T12:26:22ZengSpringerCancer Immunology, Immunotherapy1432-08512025-02-0174311210.1007/s00262-024-03937-6Efficacy of PD-1 blockade plus chemotherapy in patients with oncogenic-driven non-small-cell lung cancerHaowei Wang0Lei Cheng1Jian Chen2Peixin Chen3Zhuoran Tang4Qianyi Wang5Ying Ma6Chao Zhao7Xuefei Li8Tao Jiang9Fei Zhou10Xiaoxia Chen11Caicun Zhou12Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Medical Oncology, Shanghai East Hospital, Tongji University School of MedicineDepartment of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Medical Oncology, Shanghai East Hospital, Tongji University School of MedicineDepartment of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of MedicineAbstract Background PD-1 blockade plus chemotherapy has become the first-line standard of care for patients with advanced non-small-cell lung cancer (NSCLC) without oncogenic drivers. Oncogenic-driven advanced NSCLC showed limited response to PD-1 blockade monotherapy or chemotherapy alone. Whether NSCLC patients with oncogenic drivers could benefit from PD-1 blockade plus chemotherapy remains undetermined. Methods Three hundred twelve NSCLC patients with at least one oncogenic driver alteration received PD-1 plus chemotherapy or each monotherapy were retrospectively identified. Objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were compared to evaluate the therapeutic outcomes differences among patients with different oncogenic drivers. Results One hundred sixty-two patients received PD-1 blockade plus chemotherapy, 57 received PD-1 blockade monotherapy and 93 received chemotherapy alone were included. Oncogenic driver mutations including KRAS (31.4%), EGFR (28.8%), HER2 (14.7%), BRAF (10.6%), RET (7.4%), and other mutations (7.1%) were identified. Patients with oncogenic drivers who received PD-1 blockade plus chemotherapy had significantly better outcomes compared to those received PD-1 blockade or chemotherapy alone (ORR: 51% vs. 18% vs. 25%, P < 0.001; median PFS: 10.0 [95% CI: 8.9–12.6] vs. 3.7 [95% CI: 2.9–5.1] vs. 5.3 [95% CI: 4.5–6.2] months, P < 0.001; median OS: 26.0 [95% CI: 23.0–30.0] vs. 14.3 [95% CI: 9.6–19.8] vs. 16.1 [95% CI: 11.6–21.9] months, P < 0.001). The superior efficacy was consistently found in separate analyses for patients received first-line and second/third line treatments. Among individual gene alterations, patients with KRAS, EGFR, or BRAF mutations treated with PD-1 blockade plus chemotherapy achieved markedly improved PFS and OS than those received PD-1 blockade or chemotherapy alone. Multivariate Cox regression analysis revealed that PD-1 blockade plus chemotherapy was independently associated with better PFS and OS. Conclusion PD-1 blockade plus chemotherapy demonstrated superior efficacy than PD-1 blockade monotherapy or chemotherapy alone in patients with oncogenic-driven advanced NSCLC, particularly in KRAS, EGFR and BRAF subgroups. These findings suggest that PD-1 blockade plus chemotherapy may be considered as an optional treatment option for patients without available targeted therapies.https://doi.org/10.1007/s00262-024-03937-6PD-1 blockadeNon-small-cell lung cancerOncogenic driversEfficacy |
| spellingShingle | Haowei Wang Lei Cheng Jian Chen Peixin Chen Zhuoran Tang Qianyi Wang Ying Ma Chao Zhao Xuefei Li Tao Jiang Fei Zhou Xiaoxia Chen Caicun Zhou Efficacy of PD-1 blockade plus chemotherapy in patients with oncogenic-driven non-small-cell lung cancer Cancer Immunology, Immunotherapy PD-1 blockade Non-small-cell lung cancer Oncogenic drivers Efficacy |
| title | Efficacy of PD-1 blockade plus chemotherapy in patients with oncogenic-driven non-small-cell lung cancer |
| title_full | Efficacy of PD-1 blockade plus chemotherapy in patients with oncogenic-driven non-small-cell lung cancer |
| title_fullStr | Efficacy of PD-1 blockade plus chemotherapy in patients with oncogenic-driven non-small-cell lung cancer |
| title_full_unstemmed | Efficacy of PD-1 blockade plus chemotherapy in patients with oncogenic-driven non-small-cell lung cancer |
| title_short | Efficacy of PD-1 blockade plus chemotherapy in patients with oncogenic-driven non-small-cell lung cancer |
| title_sort | efficacy of pd 1 blockade plus chemotherapy in patients with oncogenic driven non small cell lung cancer |
| topic | PD-1 blockade Non-small-cell lung cancer Oncogenic drivers Efficacy |
| url | https://doi.org/10.1007/s00262-024-03937-6 |
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