Tolérance et efficacité de la combinaison anti-PD-1 et radiothérapie chez les patients porteurs de cancers bronchiques non à petites cellules métastatiques : étude rétrospective multicentrique

Abstract : Introduction: randomized prospective studies on patients with metastatic non-small–cell lung cancers (NSCLCs) showed that anti-programmed death-1 (PD-1) agents notably improved 2-year overall survival (OS) rates, compared to docetaxel. NSCLC patients now receive nivolumab and irradiation, concurrently or not. However, little is known about the safety of this combination, even though the preclinical model suggested a possible synergic effect. We analyzed NSCLC patients treated with radiotherapy and nivolumab according to the former’s timing.
Methods: we retrospectively reviewed records of a large series of metastatic NSCLC patients from three French centers, irradiated during the 6 months preceding, concomitantly or 3 months after nivolumab administration to assess nivolumab tolerance and outcomes.
Results: among 104 patients included (37 women; 67 men; median age 60.3 years; 67% with performance status <2; 93.2% were current or past smokers) and their 144 intra- or extracranial irradiation courses, any-grade adverse events (AEs) were observed in 62 (59.6%), with 10 (9.6%) experiencing at least one grade-3/4 toxicity and 9 (8.7%) at least one grade-3/4 immune-related AE. Respective 1- and 2-year OS rates were 48.8% and 29.1%, while 1- and 2-year progression-free survival (PFS) rates were 20.9% and 10.1%. Delivering radiation before or during/after nivolumab administration was not associated with better OS or PFS.
Conclusion: radiotherapy delivered before or during/after nivolumab for NSCLCs was not associated with an increased risk of severe or unexpected toxicities.
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Paul Lesueur. Tolérance et efficacité de la combinaison anti-PD-1 et radiothérapie chez les patients porteurs de cancers bronchiques non à petites cellules métastatiques : étude rétrospective multicentrique. Médecine humaine et pathologie. 2018. ⟨dumas-02044743⟩

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