Pembrolizumab as first-line treatment for advanced NSCLC in older adults: A phase II clinical trial evaluating geriatric and quality-of-life outcomes
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Le résumé fourni par la source
OBJECTIVES: Since specific data on immunotherapy in older adults with advanced non-small cell lung cancer (aNSCLC) are scarce, we designed this study to determine the overall survival (OS) at one year of first-line pembrolizumab in patients older than 70 years with aNSCLC expressing PD-L1. Secondary objectives included progression-free survival, disease-specific survival, response rate, tolerability, quality of life (QoL) changes, and geriatric assessments. MATERIALS AND METHODS: A single-arm, open-label, phase II clinical trial was carried out by the Spanish Lung Cancer Group between February 2018 and November 2019 at ten active sites in Spain. We included patients 70 years old and older with histological or cytological documented stage IIIB or IV aNSCLC and PD-L1 expression ≥ 1%. Each subject received 200 mg of intravenous pembrolizumab every three weeks for a maximum of two years. RESULTS: 83 patients were recruited for the study and 74 were finally analysed. Most were male (N = 64, 86.5%) and former smokers (N = 51, 68.9%). 24 patients (32.4%) completed at least one year of treatment, 62 (83.7%) discontinued treatment, and 30 (40.5%) experienced disease progression. The median follow-up of our cohort was 18.0 months [range: 0.1-47.7] and 46 patients (62.2%) died during the period of study. The estimated OS at one year was 61.7% (95% CI: 49.6-71.8%) and the median OS of our cohort was 19.2 months (95% CI: 11.3-25.5). QoL tended to improve throughout the study, although the differences were not statistically significant. The main geriatric scores remained stable, except for a worsening in nutritional status (P = 0.004) and an improvement in frailty (P = 0.028). CONCLUSION: Our results support treating older adults with aNSCLC expressing PD-L1 with pembrolizumab in monotherapy. The stability of most geriatric scores and the positive trend on the patients' QoL should be highlighted, although our results did not reach statistical significance.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Pembrolizumab as first-line treatment for advanced NSCLC in older adults: A phase II clinical trial evaluating geriatric and quality-of-life outcomes
- Date Crossref
- 01/09/2023
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Consorci Sanitari de Terrassa pays non établi dans la noticeÉtablissement de santé
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Hospital Universitario Fundación Jiménez Díaz Department of Medical Oncology pays non établi dans la noticeÉtablissement de santé
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Hospital Clínico San Carlos Department of Medical Oncology pays non établi dans la noticeÉtablissement de santé
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Institut Català d'Oncologia Department of Medical Oncology pays non établi dans la noticeOrganisme public
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Hospital Universitario Lucus Augusti Department of Medical Oncology pays non établi dans la noticeÉtablissement de santé
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Hospital Universitario Lluís Alcanyís pays non établi dans la noticeÉtablissement de santé
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Hospital de Sant Pau pays non établi dans la noticeÉtablissement de santé
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Hospital Universitario Miguel Servet Department of Medical Oncology pays non établi dans la noticeÉtablissement de santé
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Hospital Universitario Doctor Peset Department of Medical Oncology pays non établi dans la noticeÉtablissement de santé
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Hospital Virgen de la Luz Department of Medical Oncology pays non établi dans la noticeÉtablissement de santé
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Department of Medical Oncology pays non établi dans la noticeInstitution
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Department of Geriatrics pays non établi dans la noticeInstitution
Consorci Sanitari de Terrassa, Department of Medical Oncology — Hospital Universitario Fundación Jiménez Díaz et Department of Medical Oncology — Hospital Clínico San Carlos, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.