PMID- 36248788 OWN - NLM STAT- MEDLINE DCOM- 20221018 LR - 20221020 IS - 1664-3224 (Electronic) IS - 1664-3224 (Linking) VI - 13 DP - 2022 TI - PD-1 inhibition plus platinum-based chemotherapy (PBC) or PBC alone in the first-line treatment of locally advanced or metastatic pulmonary lymphoepithelioma-like carcinoma. PG - 1015444 LID - 10.3389/fimmu.2022.1015444 [doi] LID - 1015444 AB - BACKGROUND: Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a distinctive subtype of non-small cell lung carcinoma that was not well presented in clinical studies. The management of advanced PLELC remains an important, unmet need due to the paucity of high-grade evidence. Herein, we carried out a multicenter, retrospective study to assess the effectiveness and tolerability of PD-1/PD-L1 inhibitor plus chemotherapy versus chemotherapy alone for patients with advanced PLELC in the first-line setting. PATIENTS AND METHODS: This retrospective study enrolled patients with advanced PLELC receiving first-line treatment with PD-1 inhibition plus chemotherapy (IO-Chemo group) or chemotherapy alone (Chemo group) in three medical centers in China. The survival outcomes, efficacy, and safety profile were investigated. The primary endpoint was progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), overall survival (OS), and adverse events (AEs). RESULTS: A total of 133 patients were enrolled. PFS was significantly longer in the IO-Chemo group (median 12.8 months [95% CI 5.2-20.4]) than that in the Chemo group (median 7.7 months [95% CI 6.8-8.6]; hazard ratio [HR] 0.48 [95% CI 0.31-0.74]; P=0.001). ORR was 74.5% (95% CI, 63.0-86.1) in the IO-Chemo group and 34.6% (95% CI, 24.1-45.2) in the Chemo group (P<0.001). The median OS was not reached in the IO-Chemo group versus 35.7 months (95% CI 26.7-44.8) in the Chemo group (HR 0.47 [95% CI 0.20-1.07]; P=0.065). Multivariate analysis revealed that PD-1/PD-L1 inhibitor combination was independently associated with longer PFS (HR 0.40 [95% CI 0.25-0.63]; P<0.001). Grade 3 or higher AEs occurred in 36 (65.5%) patients in the IO-Chemo group and 56 (71.8%) patients in the Chemo group, respectively. CONCLUSIONS: In patients with advanced PLELC, adding PD-1/PD-L1 inhibitor to platinum-based chemotherapy significantly increased PFS and ORR with a tolerable safety profile. CI - Copyright (c) 2022 Zhang, Zhou, Chen, Chen, Lin, He, Du, Chen, Hong and Fu. FAU - Zhang, Xuanye AU - Zhang X AD - State Key Laboratory of Oncology in South China, Guangzhou, China. AD - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. AD - Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China. FAU - Zhou, Yixin AU - Zhou Y AD - State Key Laboratory of Oncology in South China, Guangzhou, China. AD - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. AD - Department of Very Important Person (VIP) Region, Sun Yat-sen University Cancer Center, Guangzhou, China. FAU - Chen, Hualin AU - Chen H AD - Department of Pulmonary Oncology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China. FAU - Chen, Chen AU - Chen C AD - State Key Laboratory of Oncology in South China, Guangzhou, China. AD - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. AD - Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China. FAU - Lin, Zuan AU - Lin Z AD - State Key Laboratory of Oncology in South China, Guangzhou, China. AD - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. AD - Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China. FAU - He, Li-Na AU - He LN AD - State Key Laboratory of Oncology in South China, Guangzhou, China. AD - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. AD - Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China. FAU - Du, Wei AU - Du W AD - State Key Laboratory of Oncology in South China, Guangzhou, China. AD - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. AD - Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China. FAU - Chen, Tao AU - Chen T AD - State Key Laboratory of Oncology in South China, Guangzhou, China. AD - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. AD - Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. FAU - Hong, Shaodong AU - Hong S AD - State Key Laboratory of Oncology in South China, Guangzhou, China. AD - Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. AD - Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China. FAU - Fu, Sha AU - Fu S AD - Department of Cellular and Molecular Diagnostics Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. AD - Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20220929 PL - Switzerland TA - Front Immunol JT - Frontiers in immunology JID - 101560960 RN - 0 (Immune Checkpoint Inhibitors) RN - 0 (Programmed Cell Death 1 Receptor) RN - 49DFR088MY (Platinum) SB - IM MH - *Carcinoma, Squamous Cell/drug therapy MH - Humans MH - Immune Checkpoint Inhibitors/adverse effects MH - *Lung Neoplasms/pathology MH - Platinum/therapeutic use MH - Programmed Cell Death 1 Receptor MH - Retrospective Studies PMC - PMC9559223 OTO - NOTNLM OT - PD-1 OT - PD-L1 OT - chemotherapy OT - immunotherapy OT - pulmonary lymphoepithelioma-like carcinoma COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/10/18 06:00 MHDA- 2022/10/19 06:00 PMCR- 2022/01/01 CRDT- 2022/10/17 05:12 PHST- 2022/08/09 00:00 [received] PHST- 2022/09/14 00:00 [accepted] PHST- 2022/10/17 05:12 [entrez] PHST- 2022/10/18 06:00 [pubmed] PHST- 2022/10/19 06:00 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fimmu.2022.1015444 [doi] PST - epublish SO - Front Immunol. 2022 Sep 29;13:1015444. doi: 10.3389/fimmu.2022.1015444. eCollection 2022.