简要报告：免疫检查点抑制剂在局部晚期 NSCLC 患者中的临床疗效与输注时机有关

IF 3 Q2 ONCOLOGY

JTO Clinical and Research Reports Pub Date : 2024-04-01 DOI:10.1016/j.jtocrr.2024.100659

Tsuyoshi Hirata MD , Yuji Uehara MD , Taiki Hakozaki MD , Takayuki Kobayashi MD , Yuto Terashima MD , Kageaki Watanabe MD , Makiko Yomota MD, PhD , Yukio Hosomi MD, PhD

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引用次数: 0

摘要

导言先前的研究报道了免疫检查点抑制剂输注时机与转移性NSCLC治疗效果之间的关系。本研究评估了局部晚期NSCLC患者输注durvalumab的时间与生存结果之间的关系。方法回顾性分析了在一家机构接受化放疗后输注durvalumab的局部晚期NSCLC患者，并评估了下午3点后输注durvalumab的比例大于或等于20%与小于20%与无进展生存期（PFS）和总生存期之间的关系。结果共纳入82名患者，中位年龄为69岁（四分位间范围为62-74岁）；其中67名患者（82%）为男性，78名患者（95%）有吸烟史。每位患者的杜伐单抗输注次数中位数为16次（四分位间范围为8-24次）。下午 3 点后输注至少 20% 杜伐单抗的患者（n = 12/82，15%）的 PFS 明显短于未在下午 3 点后输注杜伐单抗的患者（中位数为 7.4 个月，无数据）：中位数：7.4 个月，而无数据[NA]；危险比[HR]，2.43；95% 置信区间[CI]：1.11-5.34，p = 0.027），而前者的总生存期比后者短（中位数：22.4 个月比 NA；HR，1.80；95% 置信区间 [CI]：0.73-4.42，p = 0.20）。此外，后向逐步多变量分析和倾向得分匹配分析均显示，在下午3点后接受至少20%的杜伐单抗输注与较差的PFS显著相关（HR，2.54；95% CI：1.03-5.67，p = 0.047；HR，4.64；95% CI：1.95-11.04；p <0.001）。

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Brief Report: Clinical Outcomes by Infusion Timing of Immune Checkpoint Inhibitors in Patients With Locally Advanced NSCLC

Introduction

Previous studies reported an association between immune checkpoint inhibitor infusion timing and the treatment effect in metastatic NSCLC. The present study assessed the association between durvalumab infusion timing and survival outcomes in patients with locally advanced NSCLC.

Methods

Patients receiving durvalumab after chemoradiotherapy for locally advanced NSCLC at a single institution were retrospectively analyzed, and the association of the proportion of durvalumab infusions greater than or equal to 20% versus less than 20% after 3 PM with progression-free survival (PFS) and overall survival was assessed.

Results

A total of 82 patients were included, with a median age of 69 years (interquartile range, 62–74 years); of these, 67 patients (82%) were of male sex, and 78 patients (95%) had a history of smoking. The median number of durvalumab infusions per patient was 16 (interquartile range, 8–24). Patients with at least 20% of their durvalumab infusions after 3 PM (n = 12/82, 15%) had a significantly shorter PFS than those who did not (median: 7.4 mo versus not available [NA]; hazard ratio [HR], 2.43; 95% confidence interval [CI]: 1.11–5.34, p = 0.027), whereas overall survival was shorter among the former compared with the latter group (median: 22.4 versus NA; HR, 1.80; 95% CI: 0.73–4.42, p = 0.20). In addition, both backward stepwise multivariable analysis and propensity score–matching analysis revealed that receiving at least 20% of durvalumab infusions after 3 PM was significantly associated with worse PFS (HR, 2.54; 95% CI: 1.03–5.67, p = 0.047; and HR, 4.64; 95% CI: 1.95–11.04; p < 0.001, respectively).