Évaluation des facteurs cliniques prédictifs de réponse à l'immunothérapie dans le cancer bronchique non à petites cellules

Abstract : BACKGROUND: Despite the exciting success of immune checkpoint inhibitors (ICI) in lung cancer, only a fraction of patients responds to treatment and there is a risk for significant toxicities. Accurate predictive factors of disease control with ICI remain an unmet need. METHODS: We conducted an observational, monocentric, retrospective cohort study of patients with advanced non-small cell lung cancer (NSCLC) who received at least one cycle of ICI between April 2013 and November 2017. Analyzed variables included clinical data, disease characteristics, treatment data and outcomes. This is an exploratory study whose primary objective was to determine clinical features predictive of disease control with ICI in non-small cell lung cancer in a real-life population. The primary endpoint was the rate of patients who were alive without disease progression within 90 days following the first ICI infusion (3M-DCR). RESULTS: Of 415 patients included in our study, median age was 61. Two thirds were men, 21% had an ECOG performance status (PS) ≥ 2, 11.1 % were underweight, 51%, 21.9% and 6.7% were normal, overweight and obese, respectively. The 3M-DCR was 51.9%. The overall response rate (ORR) was 17.1%. The median progression-free survival (PFS) and overall survival (OS) were 3.6 and 13.4 months, respectively. ECOG PS 0-1 and the presence of immune-related adverse events (IRAEs) were significantly associated with better outcome in 3M-DCR, ORR, PFS and OS. Obese patients achieved better PFS (median PFS 9.4 months) and OS (median OS 22 months) than non-obese patients (p<0.02) whereas patients with low BMI had poorer 3M-DCR, ORR and OS. CONCLUSIONS: PS 0-1, obesity and IRAEs were identified as clinical predictive factors of better outcomes in NSCLC patients treated with immunotherapy.
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Pierre-Henri Aussedat. Évaluation des facteurs cliniques prédictifs de réponse à l'immunothérapie dans le cancer bronchique non à petites cellules. Sciences du Vivant [q-bio]. 2018. ⟨dumas-01977844⟩

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