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Efficacy of anti-PD-1 therapy for recurrence after chemoradiotherapy in locally advanced NSC LC

  • Yoshiaki AminoEmail author
  • Satoru Kitazono
  • Shinya Uematsu
  • Tsukasa Hasegawa
  • Takahiro Yoshizawa
  • Ken Uchibori
  • Noriko Yanagitani
  • Atsushi Horiike
  • Takeshi Horai
  • Kazuo Kasahara
  • Makoto Nishio
Original Article
  • 20 Downloads

Abstract

Purpose

Chemoradiotherapy (CRT) is the standard treatment for locally advanced non-small cell lung cancer (NSCLC). Recently, anti-PD-1 antibody therapy became a key treatment for stage IV NSCLC as the combination of immune checkpoint inhibitors (ICIs) and platinum doublet chemotherapy. However, the efficacy and toxicity of anti-PD-1 therapy for recurrence after CRT in stage III NSCLC are not well examined.

Methods

Patients who received anti-PD-1 therapy for recurrence after CRT were identified in our clinical database. The safety and efficacy of anti-PD-1 therapy were retrospectively analyzed.

Results

From March 1, 2013 to April 30, 2018, there were 20 patients who received anti-PD-1 therapy for recurrence after CRT. The median duration from CRT to initial anti-PD-1 therapy was 9.3 months. 12 patients (60%) were alive and 7 patients (35%) were still receiving anti-PD-1 therapy at the data cutoff point (median follow-up, 13.5 months). The ORR for anti-PD-1 therapy was 45.0%. Median progression-free survival (PFS) and overall survival (OS) from initiation of anti-PD-1 therapy was 8.4 months and 26.2 months, respectively. PFS in patients who had a short interval from last CRT to initial anti-PD-1 therapy seemed to have better outcomes (duration from last CRT to initial anti-PD-1 therapy < 9.3 months vs. ≥ 9.3 months; median PFS, 17.0 months vs. 4.9 months). Grade 3 or 4 immune-related adverse events occurred in 5% of patients. Only grade 1 pneumonitis was observed.

Conclusion

The efficacy of anti-PD-1 therapy for recurrence after CRT in stage III NSCLC might better than in stage IV NSCLC. The duration from CRT to initial anti-PD-1 therapy might be related to efficacy.

Keywords

Non-small cell lung cancer Chemoradiotherapy Anti-PD-1 therapy 

Notes

Compliance with ethical standards

Conflict of interest

All the authors approved the submission this manuscript to your journal. Makoto Nishio reports honoraria from Ono, BMS, Pfizer, Chugai,Taiho Pharmac, AstraZeneca, Boehringer-ingelheim, MSD, and Novartis, research funding from Novartis, Daiichi Sankyo, Taiho Pharma, BMS, Boehringer-ingelheim, Ono Phrmaceutical, Eli Lilly, Chugai, AstraZeneca, Merck Sernon, MSD and Pfizer. Noriko Yanagitani reports employment/ledership position/ advisory role of Chugai Phrmaceutical. Atsushi Horiike reports horaria from chugai pharma, AstraZeneca, Pfizer, Ono Phrmaceutical, Bristol-Myers Squibb Japan, A2 Healthcare and MSD oncology, research funding from Chugai Pharma, MSD Oncology, Abbvie, AstraZeneca and Loxo. We agree to allow the journal to review our data if requested.

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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Yoshiaki Amino
    • 1
    Email author
  • Satoru Kitazono
    • 1
  • Shinya Uematsu
    • 1
  • Tsukasa Hasegawa
    • 1
  • Takahiro Yoshizawa
    • 1
  • Ken Uchibori
    • 1
  • Noriko Yanagitani
    • 1
  • Atsushi Horiike
    • 1
  • Takeshi Horai
    • 1
  • Kazuo Kasahara
    • 2
  • Makoto Nishio
    • 1
  1. 1.Department of Thoracic Medical OncologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchKotoJapan
  2. 2.Hematology/Respiratory Medicine, Kanazawa University Faculty of MedicineInstitute of Medical, Pharmaceutical and Health SciencesKanazawaJapan

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