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Open Access 01-12-2024 | Checkpoint Inhibitors | Research

Immune checkpoint inhibitor plus chemotherapy as first-line treatment for non-small cell lung cancer with malignant pleural effusion: a retrospective multicenter study

Authors: Qi Wei, Taibing Deng, Junhua Wu, Hao Zeng, Chang Qi, Sihan Tan, Yuanyuan Zhang, Qin Huang, Xin Pu, Weiguo Xu, Weimin Li, Panwen Tian, Yalun Li

Published in: BMC Cancer | Issue 1/2024

Abstract

Background

Immune checkpoint inhibitors (ICI) combined with chemotherapy are efficacious for treating advanced non-small cell lung cancer (NSCLC); however, the effectiveness of this approach in the malignant pleural effusion (MPE) population is unclear. This study evaluated ICI plus chemotherapy in NSCLC patients with MPE.

Methods

Patients from 3 centers in China with NSCLC and MPE who received ICI plus chemotherapy (ICI Plus Chemo) or chemotherapy alone (Chemo) between December 2014 and June 2023 were enrolled. Clinical outcomes and adverse events (AEs) were compared.

Results

Of 155 eligible patients, the median age was 61.0 years old. Males and never-smokers accounted for 73.5% and 39.4%, respectively. Fifty-seven and 98 patients received ICI Plus Chemo or Chemo, respectively. With a median study follow-up of 10.8 months, progression-free survival (PFS) was significantly longer with ICI Plus Chemo than with Chemo (median PFS: 7.4 versus 5.7 months; HR = 0.594 [95% CI: 0.403–0.874], P = 0.008). Median overall survival (OS) did not differ between groups (ICI Plus Chemo: 34.2 versus Chemo: 28.3 months; HR = 0.746 [95% CI: 0.420–1.325], P = 0.317). The most common grade 3 or worse AEs included decreased neutrophil count (3 [5.3%] patients in the ICI Plus Chemo group vs. 5 [5.1%] patients in the Chemo group) and decreased hemoglobin (3 [5.3%] versus 10 [10.2%]).

Conclusions

In patients with untreated NSCLC with MPE, ICI plus chemotherapy resulted in significantly longer PFS than chemotherapy and had a manageable tolerability profile, but the effect on OS may be limited.

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Title: Immune checkpoint inhibitor plus chemotherapy as first-line treatment for non-small cell lung cancer with malignant pleural effusion: a retrospective multicenter study
Authors: Qi Wei
Taibing Deng
Junhua Wu
Hao Zeng
Chang Qi
Sihan Tan
Yuanyuan Zhang
Qin Huang
Xin Pu
Weiguo Xu
Weimin Li
Panwen Tian
Yalun Li
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Checkpoint Inhibitors
Cytostatic Therapy
NSCLC
NSCLC
Pleural Effusion
Pleurodesis
Published in: BMC Cancer / Issue 1/2024
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-024-12173-1

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