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Short Communication

Immunotherapy in advanced non-small-cell lung cancer (NSCLC) after progression on chemotherapy: real-world results from a prospective institutional cohort

    Ullas Batra

    Department of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085, India

    ,
    Kundan Singh Chufal

    Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085, India

    ,
    Shrinidhi Nathany

    Department of Molecular Diagnostics, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085, India

    ,
    Irfan Ahmad

    *Author for correspondence: Tel.: +91 11 4702 2012;

    E-mail Address: irfan.a@icloud.com

    Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085, India

    ,
    Rahul Lal Chowdhary

    Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085, India

    ,
    Mansi Sharma

    Department of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085, India

    ,
    Praveen Jain

    Department of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085, India

    &
    Munish Gairola

    Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085, India

    Published Online:https://doi.org/10.2217/imt-2021-0170

    Objective: To analyze the outcomes of patients receiving immunotherapy (IO) with advanced non-driver mutated non-small-cell lung cancer (NSCLC) after progression on systemic treatment. Methods: The overall survival (OS), progression-free survival (PFS) and best response to IO of 64 patients who met our inclusion criteria were analyzed. Results: Median follow-up, OS and PFS were 35.9, 7.1 and 3.2 months, respectively. On uni- and multi-variable analysis, better ECOG PS and fewer extra-thoracic metastases were associated with prolonged OS and PFS. Response to IO was associated with prolonged OS, while thoracic radiotherapy and isolated CNS involvement were associated with prolonged PFS. ECOG PS, thoracic radiotherapy and PDL1 status significantly influenced the likelihood of response to IO. Overall, 30% patients experienced any grade toxicity. Conclusion: Our results are concordant with reported trial outcomes and support the application of IO in Indian patients.

    Plain language summary

    Several clinical trials have demonstrated favorable results with immunotherapy in patients with lung cancer who do not have a mutation in their tumors. However, clinical trials are often designed to provide the best chance for a trial drug/intervention to demonstrate effectiveness. Therefore, they usually include relatively healthier patients compared to what clinicians see in their practice. To demonstrate the efficacy of a drug outside a clinical trial, a real-world analysis is performed, which is reported in this article. We analyzed lung cancer patients treated with immunotherapy at our institution and found comparable efficacy to reported clinical trials. This was important because the trials did not include any patients from our country. We also found that patients with fewer sites of involvement outside the lung and those who received radiotherapy to the lung (either during or before receiving immunotherapy) survived longer without disease progression.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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