IMMUNOPROG : inhibiteurs de point de contrôle immunitaire versus chimiothérapie de deuxième ligne chez des patients porteurs d’un carcinome bronchique non à petites cellules réfractaire à une chimiothérapie de première ligne

Abstract : Purpose: anti-PD1/PD-L1 directed immune-checkpoint-inhibitors (ICI) are widely used to treat patients with advanced non-small cell lung cancer (NSCLC) who progress after first line chemotherapy. The best strategy after early progression under first line has not been specially studied. Patients and Methods: we conducted a multicenter, retrospective study between March 2010 and November 2017 in patients with NSCLC progressing within the first 3 months after introduction of first-line chemotherapy. We analyzed the clinicopathological data and outcome under second line chemotherapy vs second line immunotherapy: progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). Results: we analyzed the data of 176 patients, 99 who received immunotherapy and 77 received chemotherapy. The 2 populations were comparable regarding the main prognostic criteria. In comparison with chemotherapy, immunotherapy showed an improvement in overall survival (Median OS 4.6 months [2.8; 6.7] versus 4.2 months [3.4; 5.9] and seems to improve objective response rate (17.2% and 7.9%, respectively (p = 0.0718). Progression-free survival was not different between both treatments (1.9 months [1.77; 2.10] versus 1.6 months for ICI [1.38; 2.04] (p=0.1248). The poor performance status and the number of metastatic sites were associated with poorer prognosis. KRAS altered patients did not seem to benefit more from ICI than chemotherapy Conclusions: ICI appears to be the preferred second-line treatment for patients refractory to first line chemotherapy.
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Corentin Lefebvre. IMMUNOPROG : inhibiteurs de point de contrôle immunitaire versus chimiothérapie de deuxième ligne chez des patients porteurs d’un carcinome bronchique non à petites cellules réfractaire à une chimiothérapie de première ligne. Médecine humaine et pathologie. 2018. ⟨dumas-02076748⟩

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