Relationship between Programmed Cell Death Protein Ligand 1 Expression and Immune-related Adverse Events in Non-small-cell Lung Cancer Patients Treated with Pembrolizumab

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  • Sugisaka Jun
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Toi Yukihiro
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Taguri Masataka
    Department of Data Science, Yokohama City University school of Data Science, Yokohama, Japan
  • Kawashima Yosuke
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Aiba Tomoiki
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Kawana Sachiko
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Saito Ryohei
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Aso Mari
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Tsurumi Kyoji
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Suzuki Kana
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Shimizu Hisashi
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Ono Hirotaka
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Domeki Yutaka
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Terayama Keisuke
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Nakamura Atsushi
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Yamanda Shinsuke
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Kimura Yuichiro
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Honda Yoshihiro
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
  • Sugawara Shunichi
    Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan

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<p>Introduction: Immune checkpoint inhibitors (ICIs) can lead to immune-related adverse events (irAEs). A correlation between the development of irAEs and efficacy has been suggested; however, it is unclear whether there is a relationship between programmed death ligand 1 (PD-L1) expression and the development of these events.</p><p>Methods: We performed a retrospective study of advanced or metastatic non-small cell lung cancer (NSCLC) patients who were treated with pembrolizumab monotherapy at our institution between May 2015 and April 2018 (n = 44). Patients were categorized into two groups, specifically those with irAEs (irAE group) or without (non-irAE group), and we evaluated the objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS). Predictors of irAEs were examined by multivariate analysis.</p><p>Results: irAEs of any grade occurred in 31 (70.5%) patients. The median PFS was 10.9 months in the irAE group versus 3.7 months in the non-irAE group (P < 0.001). ORR and DCR were also higher in the irAE group than in the non-irAE group. Furthermore, high PD-L1 expression (≥50%) was a predictive factor of irAE based on logistic regression (P = 0.004).</p><p>Conclusions: In patients with advanced NSCLC treated with pembrolizumab monotherapy, ORR, DCR, and PFS were significantly better in the irAE group than in the non-irAE group. High PD-L1 expression, at the time of pretreatment, was identified as an independent predictor of irAE development. We believe that more careful management of irAEs for individuals with high PD-L1 expression is needed to improve clinical benefits. Further, PD-L1 expression might be useful for ICI risk management.</p>

収録刊行物

  • JMA Journal

    JMA Journal 3 (1), 58-66, 2020-01-15

    公益社団法人 日本医師会 / 日本医学会

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