Background: Bone metastases (BoM) are a negative prognostic factor in non-small-cell lung cancer (NSCLC). Beyond its supportive role, bone is a hematopoietic organ actively regulating immune system. We hypothesized that BoM may influence sensitivity to immunotherapy. Methods: Pretreated non-squamous (cohort A) and squamous (cohort B) NSCLCs included in the Italian Expanded Access Program were evaluated for nivolumab efficacy according to BoM. Results: Cohort A accounted for 1588 patients with non-squamous NSCLC, including 626 (39%) with (BoM+) and 962 (61%) without BoM (BoM-). Cohort B accounted for 371 patients with squamous histology including 120 BoM+ (32%) and 251 (68%) BoM- cases. BoM+ had lower overall response rate (ORR; Cohort A: 12% versus 23%, p < 0.0001; Cohort B: 13% versus 22%, p = 0.04), shorter progression free survival (PFS; Cohort A: 3.0 versus 4.0 months, p < 0.0001; Cohort B: 2.7 versus 5.2 months, p < 0.0001) and overall survival (OS; Cohort A: 7.4 versus 15.3 months, p < 0.0001; Cohort B: 5.0 versus 10.9 months, p < 0.0001). Moreover, BoM negatively affected outcome irrespective of performance status (PS; OS in both cohorts: p < 0.0001) and liver metastases (OS cohort A: p < 0.0001; OS Cohort B: p = 0.48). At multivariate analysis, BoM independently associated with higher risk of death (cohort A: HR 1.50; cohort B: HR 1.78). Conclusions: BoM impairs immunotherapy efficacy. Accurate bone staging should be included in clinical trials with immunotherapy.

Landi, L., D'Inca, F., Gelibter, A., Chiari, R., Grossi, F., Delmonte, A., et al. (2019). Bone metastases and immunotherapy in patients with advanced non-small-cell lung cancer. JOURNAL FOR IMMUNOTHERAPY OF CANCER, 7(1) [10.1186/s40425-019-0793-8].

Bone metastases and immunotherapy in patients with advanced non-small-cell lung cancer

Bidoli P.;
2019

Abstract

Background: Bone metastases (BoM) are a negative prognostic factor in non-small-cell lung cancer (NSCLC). Beyond its supportive role, bone is a hematopoietic organ actively regulating immune system. We hypothesized that BoM may influence sensitivity to immunotherapy. Methods: Pretreated non-squamous (cohort A) and squamous (cohort B) NSCLCs included in the Italian Expanded Access Program were evaluated for nivolumab efficacy according to BoM. Results: Cohort A accounted for 1588 patients with non-squamous NSCLC, including 626 (39%) with (BoM+) and 962 (61%) without BoM (BoM-). Cohort B accounted for 371 patients with squamous histology including 120 BoM+ (32%) and 251 (68%) BoM- cases. BoM+ had lower overall response rate (ORR; Cohort A: 12% versus 23%, p < 0.0001; Cohort B: 13% versus 22%, p = 0.04), shorter progression free survival (PFS; Cohort A: 3.0 versus 4.0 months, p < 0.0001; Cohort B: 2.7 versus 5.2 months, p < 0.0001) and overall survival (OS; Cohort A: 7.4 versus 15.3 months, p < 0.0001; Cohort B: 5.0 versus 10.9 months, p < 0.0001). Moreover, BoM negatively affected outcome irrespective of performance status (PS; OS in both cohorts: p < 0.0001) and liver metastases (OS cohort A: p < 0.0001; OS Cohort B: p = 0.48). At multivariate analysis, BoM independently associated with higher risk of death (cohort A: HR 1.50; cohort B: HR 1.78). Conclusions: BoM impairs immunotherapy efficacy. Accurate bone staging should be included in clinical trials with immunotherapy.
Articolo in rivista - Articolo scientifico
Bone metastases; Immunotherapy; Nivolumab; Non-small-cell lung cancer; PD-L1;
Bone metastases
Immunotherapy
Nivolumab
Non-small-cell lung cancer
PD-L1
Adult
Aged
Aged, 80 and over
Antineoplastic Agents, Immunological
Biomarkers, Tumor
Bone Neoplasms
Carcinoma, Non-Small-Cell Lung
Clinical Trials as Topic
Cohort Studies
Female
Humans
Lung Neoplasms
Male
Middle Aged
Prognosis
Treatment Outcome
Molecular Targeted Therapy
English
2019
7
1
316
open
Landi, L., D'Inca, F., Gelibter, A., Chiari, R., Grossi, F., Delmonte, A., et al. (2019). Bone metastases and immunotherapy in patients with advanced non-small-cell lung cancer. JOURNAL FOR IMMUNOTHERAPY OF CANCER, 7(1) [10.1186/s40425-019-0793-8].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/281350
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