Outcomes of Pembrolizumab plus chemotherapy for patients with metastatic non-squamous NSCLC: Real-world evidence.

IF 6.4 2区医学 Q1 RESPIRATORY SYSTEM

Pulmonology Pub Date : 2025-12-31 Epub Date: 2025-02-05 DOI:10.1080/25310429.2025.2457856

Irina Surovtsova, Felix J F Herth, Daria B Kokh, Philipp Morakis

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引用次数: 0

Abstract

Background: Pembrolizumab with chemotherapy (immunochemotherapy) has shown encouraging overall survival (OS) benefits in non-squamous mNSCLC, as demonstrated by the KEYNOTE-189 trial. However, randomised controlled trials may not fully capture the diversity of real-world patients. This study aims to evaluate immunochemotherapy outcomes in a real-world setting, including subgroups underrepresented in the KEYNOTE-189 trial.

Methods: Patients diagnosed with non-squamous mNSCLC 2011-2022 and recorded in Cancer Registry Database of the German Federal State Baden-Württemberg (BWCR), were analysed. OS was assessed using Kaplan-Meier and multivariable Cox models, adjusted for major clinical parameters. Results were compared with KEYNOTE-189.

Results: Among 2630 eligible cases, 1314 patients received chemotherapy alone and 1316 received immunochemotherapy. Median OS (mOS) was 14.1 months (95%CI: 13.1-15.4) for immunochemotherapy and 10.4 months (95%CI: 9.7-11.2) for chemotherapy alone, with an HR of 0.7 (95%CI: 0.64-0.77). A significant benefit was seen in M1c stage (HR 0.7, 95%CI: 0.63-0.79). No significant OS improvement was observed in patients with ECOG 2-3 or bone metastases.

Conclusion: This real-world evidence suggests that immunochemotherapy generally improves OS in mNSCLC. Subgroup analysis showed no survival benefit for patients with ECOG >1 or bone metastasis, but a benefit for patients with M1c stage.

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Pembrolizumab联合化疗治疗转移性非鳞状NSCLC患者的结果：真实世界证据

背景：KEYNOTE-189试验表明，派姆单抗联合化疗（免疫化疗）在非鳞状小细胞肺癌中显示出令人鼓舞的总生存（OS）益处。然而，随机对照试验可能无法完全捕捉现实世界患者的多样性。本研究旨在评估现实环境中的免疫化疗结果，包括KEYNOTE-189试验中代表性不足的亚组。方法：分析2011-2022年诊断为非鳞状小细胞肺癌并记录在德国联邦州巴登-符腾堡州（BWCR）癌症登记数据库中的患者。采用Kaplan-Meier和多变量Cox模型评估OS，并根据主要临床参数进行调整。结果与KEYNOTE-189比较。结果：2630例符合条件的患者中，单独化疗1314例，免疫化疗1316例。免疫化疗的中位OS （mOS）为14.1个月（95%CI: 13.1-15.4），单独化疗的中位OS （mOS）为10.4个月（95%CI: 9.7-11.2）， HR为0.7 （95%CI: 0.64-0.77）。在M1c期观察到显著的获益（危险度0.7,95%CI: 0.63-0.79）。ECOG 2-3或骨转移患者未观察到明显的OS改善。结论：这一现实证据表明，免疫化疗通常可以改善小细胞肺癌的OS。亚组分析显示，ECOG bbb1或骨转移患者没有生存获益，但对M1c期患者有获益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pulmonology Medicine-Pulmonary and Respiratory Medicine

CiteScore

14.30

自引率

5.10%

发文量

159

审稿时长

19 days

期刊介绍： Pulmonology (previously Revista Portuguesa de Pneumologia) is the official journal of the Portuguese Society of Pulmonology (Sociedade Portuguesa de Pneumologia/SPP). The journal publishes 6 issues per year and focuses on respiratory system diseases in adults and clinical research. It accepts various types of articles including peer-reviewed original articles, review articles, editorials, and opinion articles. The journal is published in English and is freely accessible through its website, as well as Medline and other databases. It is indexed in Science Citation Index Expanded, Journal of Citation Reports, Index Medicus/MEDLINE, Scopus, and EMBASE/Excerpta Medica.