PMID- 34510271 OWN - NLM STAT- MEDLINE DCOM- 20220805 LR - 20220805 IS - 1432-1335 (Electronic) IS - 0171-5216 (Linking) VI - 148 IP - 9 DP - 2022 Sep TI - Early discontinuation of induction therapy in chemoimmunotherapy as an effective alternative to the standard regimen in patients with non-small cell lung cancer: a retrospective study. PG - 2437-2446 LID - 10.1007/s00432-021-03782-5 [doi] AB - PURPOSE: We aimed to investigate whether induction chemotherapy with less than four courses is as effective as induction chemotherapy with more than four courses in non-small cell lung cancer (NSCLC) patients receiving chemoimmunotherapy. METHODS: We retrospectively enrolled 249 patients with NSCLC who received chemoimmunotherapy at 12 centers in Japan between January and December 2019. The patient group that completed less than four courses owing to adverse events (AEs), and received subsequent maintenance therapy was compared to the group that received at least four courses of induction chemotherapy followed by maintenance therapy. RESULTS: On univariate and multivariate analyses, the patient group that transitioned to maintenance therapy after completing less than four courses of induction chemotherapy had significantly shorter progression-free survival (PFS) than those who completed at least four courses (hazard ratio [HR] 2.15, 95% confidence interval: 1.38-3.37, p < 0.001 and HR 2.32, 95% confidence interval: 1.40-3.84, p = 0.001, respectively). There was no obvious difference in PFS between the group in which induction chemotherapy ended in two or three courses leading to partial or complete response, and the group that continued at least four courses of induction chemotherapy (log-rank test p = 0.53). CONCLUSION: Treatment efficacy may be maintained if induction chemotherapy is completed in less than four courses owing to development of AEs, and is administered for more than two courses with partial or complete response; efficacy is maintained even on transitioning to maintenance therapy. CI - (c) 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Morimoto, Kenji AU - Morimoto K AD - Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Uchino, Junji AU - Uchino J AUID- ORCID: 0000-0003-0651-7767 AD - Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan. uchino@koto.kpu-m.ac.jp. FAU - Yokoi, Takashi AU - Yokoi T AD - Department of Thoracic Oncology, Hyogo College of Medicine, Hyogo, Japan. FAU - Kijima, Takashi AU - Kijima T AD - Department of Thoracic Oncology, Hyogo College of Medicine, Hyogo, Japan. FAU - Goto, Yasuhiro AU - Goto Y AD - Department of Respiratory Medicine, Fujita Health University, Aichi, Japan. FAU - Nakao, Akira AU - Nakao A AD - Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. FAU - Hibino, Makoto AU - Hibino M AD - Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan. FAU - Takeda, Takayuki AU - Takeda T AD - Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan. FAU - Yamaguchi, Hiroyuki AU - Yamaguchi H AD - Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. FAU - Takumi, Chieko AU - Takumi C AD - Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan. FAU - Takeshita, Masafumi AU - Takeshita M AD - Department of Respiratory Medicine, Ichinomiyanishi Hospital, Aichi, Japan. FAU - Chihara, Yusuke AU - Chihara Y AD - Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan. FAU - Yamada, Takahiro AU - Yamada T AD - Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan. FAU - Hiranuma, Osamu AU - Hiranuma O AD - Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan. FAU - Morimoto, Yoshie AU - Morimoto Y AD - Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Iwasaku, Masahiro AU - Iwasaku M AD - Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Kaneko, Yoshiko AU - Kaneko Y AD - Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Yamada, Tadaaki AU - Yamada T AD - Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan. FAU - Takayama, Koichi AU - Takayama K AD - Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan. LA - eng PT - Journal Article DEP - 20210912 PL - Germany TA - J Cancer Res Clin Oncol JT - Journal of cancer research and clinical oncology JID - 7902060 SB - IM MH - Antineoplastic Combined Chemotherapy Protocols/adverse effects MH - *Carcinoma, Non-Small-Cell Lung/drug therapy MH - Humans MH - Induction Chemotherapy MH - *Lung Neoplasms/drug therapy/etiology MH - Retrospective Studies OTO - NOTNLM OT - Adverse events OT - Chemoimmunotherapy OT - Early discontinuation OT - Induction chemotherapy OT - Non-small cell lung cancer EDAT- 2021/09/13 06:00 MHDA- 2022/08/06 06:00 CRDT- 2021/09/12 21:10 PHST- 2021/01/25 00:00 [received] PHST- 2021/08/15 00:00 [accepted] PHST- 2021/09/13 06:00 [pubmed] PHST- 2022/08/06 06:00 [medline] PHST- 2021/09/12 21:10 [entrez] AID - 10.1007/s00432-021-03782-5 [pii] AID - 10.1007/s00432-021-03782-5 [doi] PST - ppublish SO - J Cancer Res Clin Oncol. 2022 Sep;148(9):2437-2446. doi: 10.1007/s00432-021-03782-5. Epub 2021 Sep 12.