PMID- 32426052
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220414
IS  - 1758-8340 (Print)
IS  - 1758-8359 (Electronic)
IS  - 1758-8340 (Linking)
VI  - 12
DP  - 2020
TI  - Association of immune-related pneumonitis with the efficacy of PD-1/PD-L1 
      inhibitors in non-small cell lung cancer.
PG  - 1758835920922033
LID - 10.1177/1758835920922033 [doi]
LID - 1758835920922033
AB  - BACKGROUND: Cutaneous adverse events (AEs) have been positively associated with 
      immune checkpoint inhibitor (ICI) efficacy in patients with melanoma, but little 
      is known regarding the association between checkpoint inhibitor pneumonitis (CIP) 
      and programmed cell death protein 1/programmed death ligand 1 (PD-1/PD-L1) 
      inhibitor efficacy in non-small cell lung cancer (NSCLC). METHODS: A 
      single-institution, retrospective medical record review of patients with advanced 
      or recurrent NSCLC who were treated with PD-1/PD-L1 inhibitors between 1 
      September 2015 and 1 June 2019 was conducted. A total of 276 NSCLC patients with 
      or without immune-related pneumonitis who received at least one dose of ICIs and 
      had at least one follow-up visit were identified. Kaplan-Meier curves of the 
      progression-free survival (PFS) of patients stratified according to 
      immune-related pneumonitis development were evaluated with the log-rank test as a 
      preplanned primary objective. Multivariate analysis of PFS was performed with Cox 
      proportional hazard regression models. RESULTS: In the cohort of 276 patients, 42 
      patients developed CIP attributed to PD-1/PD-L1 inhibitors. Survival analysis 
      showed that the overall response rate was significantly higher in patients with 
      CIP than in those without CIP (61.90% versus 29.91%, respectively, p < 0.01), and 
      that CIP development was significantly associated with increased PFS (45.80 weeks 
      versus 21.15 weeks, respectively, p < 0.01). Additionally, 16-week landmark 
      analysis produced the same results. Similarly, subgroup analysis of PD-1 
      inhibitor-treated, nivolumab-treated, and pembrolizumab-treated groups also 
      revealed that CIP increased survival in NSCLC patients. Additionally, grade 1-2 
      pneumonitis showed an association with increased ICI efficacy in NSCLC; however, 
      grade 3-4 pneumonitis did not. In addition, only two of the four pneumonitis 
      radiological subtypes showed associations with increased ICI efficacy in NSCLC. 
      CONCLUSION: CIP is associated with enhanced PD-1/PD-L1 inhibitor efficacy in 
      NSCLC patients. Grade 1-2 pneumonitis and the radiological features of 
      hypersensitivity and cryptogenic organizing pneumonia (COP) may be signs of 
      enhanced ICI efficacy. However, further studies with larger numbers of patients 
      and longer follow-up times are needed to validate our findings.
CI  - (c) The Author(s), 2020.
FAU - Cui, Pengfei
AU  - Cui P
AD  - Department of Graduate Administration, Chinese PLA General Hospital, 28 Fuxing 
      Road, Haidian, Beijing, China.
FAU - Huang, Di
AU  - Huang D
AD  - School of Medicine, Nankai University, Nankai, Tianjin, China.
FAU - Wu, Zhaozhen
AU  - Wu Z
AUID- ORCID: 0000-0001-8962-5741
AD  - School of Medicine, Nankai University, Nankai, Tianjin, China.
FAU - Tao, Haitao
AU  - Tao H
AD  - Department of Medical Oncology, Chinese PLA General Hospital, Haidian, Beijing, 
      China.
FAU - Zhang, Sujie
AU  - Zhang S
AD  - Department of Medical Oncology, Chinese PLA General Hospital, Haidian, Beijing, 
      China.
FAU - Ma, Junxun
AU  - Ma J
AD  - Department of Medical Oncology, Chinese PLA General Hospital, Haidian, Beijing, 
      China.
FAU - Liu, Zhefeng
AU  - Liu Z
AD  - Department of Medical Oncology, Chinese PLA General Hospital, Haidian, Beijing, 
      China.
FAU - Wang, Jinliang
AU  - Wang J
AD  - Department of Medical Oncology, Chinese PLA General Hospital, Haidian, Beijing, 
      China.
FAU - Huang, Ziwei
AU  - Huang Z
AD  - School of Medicine, Nankai University, Nankai, Tianjin, China.
FAU - Chen, Shixue
AU  - Chen S
AD  - Department of Graduate Administration, Chinese PLA General Hospital, 28 Fuxing 
      Road, Haidian, Beijing, China.
FAU - Zheng, Xuan
AU  - Zheng X
AD  - Department of Graduate Administration, Chinese PLA General Hospital, 28 Fuxing 
      Road, Haidian, Beijing, China.
FAU - Hu, Yi
AU  - Hu Y
AUID- ORCID: 0000-0003-4740-0290
AD  - Department of Medical Oncology, Chinese PLA General Hospital, 28 Fuxing Road, 
      Haidian, Beijing, 100853, China.
LA  - eng
PT  - Journal Article
DEP - 20200509
PL  - England
TA  - Ther Adv Med Oncol
JT  - Therapeutic advances in medical oncology
JID - 101510808
PMC - PMC7222233
OTO - NOTNLM
OT  - PD-1 inhibitors
OT  - PD-L1 inhibitors
OT  - efficacy
OT  - immune-related pneumonitis
OT  - non-small cell lung cancer
COIS- Conflict of interest statement: The authors declare that there is no conflict of 
      interest.
EDAT- 2020/05/20 06:00
MHDA- 2020/05/20 06:01
PMCR- 2020/05/09
CRDT- 2020/05/20 06:00
PHST- 2020/01/23 00:00 [received]
PHST- 2020/04/03 00:00 [accepted]
PHST- 2020/05/20 06:00 [entrez]
PHST- 2020/05/20 06:00 [pubmed]
PHST- 2020/05/20 06:01 [medline]
PHST- 2020/05/09 00:00 [pmc-release]
AID - 10.1177_1758835920922033 [pii]
AID - 10.1177/1758835920922033 [doi]
PST - epublish
SO  - Ther Adv Med Oncol. 2020 May 9;12:1758835920922033. doi: 
      10.1177/1758835920922033. eCollection 2020.