无法切除的III期非小细胞肺癌患者在放化疗后durvalumab巩固期早期复发的预测因素。

IF 3.5 2区医学 Q2 ONCOLOGY

Translational lung cancer research Pub Date : 2025-04-30 Epub Date: 2025-04-18 DOI:10.21037/tlcr-2024-1112

Ji Eun Park, Chanmi Kim, Sun Ha Choi, Jong Geol Jang, Kyung Soo Hong, Yong Shik Kwon, Keum-Ju Choi, Jung Seop Eom, Saerom Kim, Hee Yun Seol, Jehun Kim, Insu Kim, Jin Han Park, Tae Hoon Kim, June Hong Ahn

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引用次数: 0

摘要

背景：同步放化疗（CCRT）后Durvalumab巩固是目前无法切除的III期非小细胞肺癌（NSCLC）患者的护理标准。然而，一些患者经历早期复发。本研究寻求杜伐单抗巩固期间早期复发的危险因素。方法：该回顾性多中心研究于2017年9月至2022年9月进行。我们将患者分为早期复发组和非早期复发组。早期复发定义为首次给药后6个月内的复发。结果：222例患者中，早期复发40例（18.0%），非早期复发182例（82.0%）。前者比后者年轻（P=0.02）。程序性细胞死亡配体1 （PD-L1）表达水平较低的患者更有可能出现早期复发（P=0.02）。IIIC期患者比IIIA/IIIB期患者更容易出现早期复发（P=0.055）。多因素分析显示，老年[比值比（OR）， 0.945；95%置信区间（CI）： 0.902-0.991；P=0.02]且PD-L1水平≥50% (OR, 0.303；95% ci: 0.125-0.736；P=0.008)可预防durvalumab巩固治疗的NSCLC患者早期复发。非早期复发组的中位总生存期明显高于早期复发组(不可评估vs. 11.0个月；结论：较年轻的年龄和较低的PD-L1表达预测了CCRT后durvalumab巩固期间的早期复发。对这类病人进行仔细的随访是必要的。

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Factors predicting early recurrence in patients with unresectable stage III non-small cell lung cancer on durvalumab consolidation after chemoradiotherapy.

Background: Durvalumab consolidation after concurrent chemoradiotherapy (CCRT) is the present standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC). However, some patients experience early recurrence. This study sought risk factors for early recurrence during durvalumab consolidation.

Methods: This retrospective multicenter study was conducted between September 2017 and September 2022. We categorized patients into early and non-early recurrence groups. Early recurrence was defined as recurrence within 6 months after the first dose of durvalumab.

Results: Of the 222 patients, 40 (18.0%) experienced early recurrence and 182 (82.0%) experienced non-early recurrence. The former group was younger than the latter group (P=0.02). Patients exhibiting lower-level programmed cell death-ligand 1 (PD-L1) expression were more likely to experience early recurrence (P=0.02). Stage IIIC patients tended to experience more early recurrence than stage IIIA/IIIB patients (P=0.055). Multivariate analyses revealed that older age [odds ratio (OR), 0.945; 95% confidence interval (CI): 0.902-0.991; P=0.02] and PD-L1 level ≥50% (OR, 0.303; 95% CI: 0.125-0.736; P=0.008) protected against early recurrence in NSCLC patients on durvalumab consolidation. Median overall survival was significantly longer in the non-early recurrence group than in the early recurrence group (non-evaluable vs. 11.0 months, respectively; P<0.001).

Conclusions: Younger age and lower PD-L1 expression predicted early recurrence during durvalumab consolidation after CCRT. Careful follow-up of such patients is essential.

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来源期刊

Translational lung cancer research Medicine-Oncology

CiteScore

7.20

自引率

2.50%

发文量

137

期刊介绍： Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.