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Master Thesis

Effet de l'administration préalable d'une immunothérapie sur l'efficacité des chimiothérapies dans le cancer bronchique non à petites cellules avancé/ métastatique : étude rétrospective au CHU de Bordeaux

Abstract : Background: the potential effect of the sequential combination of immune checkpoint inhibitors (ICI) and chemotherapy remains unclear. We evaluated the efficacy of different chemotherapy regimens administered after ICI in advanced non-small cell lung cancer (NSCLC), compared to the same regimens administered without previous ICI. Methods: we retrospectively included all patients (pts) treated between 2015 and 2019 for an advanced NSCLC, receiving a salvage chemotherapy just after ICI (CAI group) comparing them to ICI naive patients (CWI) undergoing the same chemotherapy at Bordeaux University Hospital. The primary outcome was the time to treatment discontinuation (TTD), and secondary endpoints were overall survival (OS), progression free survival (PFS) and overall response rate (ORR). Results: 152 patients were included, with 34/23 (CAI/CWPI) receiving paclitaxel/bevacizumab (PB), 24/11 paclitaxel (P), 27/12 gemcitabine (G) and 6/15 pemetrexed (PE). Age and ECOG PS did not vary significantly between CAI and CWPI regardless of the chemotherapy regimen except for CAI treated with PB (more pts with an ECOG PS ≤ 1 (p<0.001)). Median line number was higher in CAI for all groups. There was no difference between CAI and CWPI in terms of TTD, OS, PFS and ORR for all groups. However, OS tended to increase in CAI treated with PB (HR=0.65; 95%CI 0.38-1.2, p=0.17]. Conclusion: our data showed no difference in TTD, OS and ORR regardless of chemotherapy, but there was a trend to an increased OS with PB when given after ICI, whereas pts received chemotherapy later in the CAI group. This suggests that a sequential combination of ICI followed by chemotherapy could be an interesting strategy in advanced NSCLC for some patients. These resuts need to be confirmed in larger cohort. However, the place of such therapeutic strategy has to be determined since combinations are validated as first-line treatment.
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https://dumas.ccsd.cnrs.fr/dumas-03586043
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Submitted on : Wednesday, February 23, 2022 - 3:13:13 PM
Last modification on : Tuesday, March 1, 2022 - 3:30:14 AM

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Tara Delon. Effet de l'administration préalable d'une immunothérapie sur l'efficacité des chimiothérapies dans le cancer bronchique non à petites cellules avancé/ métastatique : étude rétrospective au CHU de Bordeaux. Sciences du Vivant [q-bio]. 2022. ⟨dumas-03586043⟩

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