학술논문

Efficacy and safety of immune checkpoint blockade in self‐identified Black patients with advanced non–small cell lung cancer.
Document Type
Article
Source
Cancer (0008543X). Dec2020, Vol. 126 Issue 23, p5040-5049. 10p.
Subject
*NON-small-cell lung carcinoma
Language
ISSN
0008-543X
Abstract
Background: To the authors' knowledge, race‐based differences in efficacy for the treatment of patients with advanced non–small cell lung cancer (NSCLC) have not been studied to date due to the underrepresentation of patients of minority backgrounds in pivotal trials. In the current study, the authors examined real‐world differences in outcome in a diverse patient population. Methods: The authors retrospectively analyzed the clinical outcomes of patients with advanced NSCLC who were treated with single‐agent immune checkpoint blockade (ICB) between 2013 and July 2018 at Winship Cancer Institute of Emory University in Atlanta, Georgia. Primary efficacy comparison between Black patients and White patients was performed using bivariate and multivariate analyses for overall survival (OS) and progression‐free survival (PFS). Results: Data from 257 patients were analyzed. The median age of the patients was 69 years; 50.6% of the patients were female, 63.4% were White, 29.5% were Black, and 7.1% of the patients were of "other" race. ICB was the first‐line treatment in 51 patients (19.9%), the second‐line treatment in 161 patients (62.6%), and the third‐line treatment in 33 patients (12.9%). The most commonly used agents were nivolumab (49.0%), pembrolizumab (25.2%), and atezolizumab (21.3%). No differences with regard to OS (P =.839) and PFS (P =.235) were noted between Black and White patients. The sample overall response rate was 20.6% (15.2% in Black patients and 23.1% in White patients). No differences with regard to OS (P =.081) and PFS (P =.176) were observed between female and male patients. The rate of immune‐related adverse events was found to be similar in Black and White patients (20.0% vs 29.9%; P =.148). On multivariate analysis, race was not found to be significantly associated with OS or PFS. Conclusions: Real‐world analysis of the authors' institutional experience demonstrated similar efficacy and tolerability of ICB in Black versus White patients with advanced NSCLC. Larger multi‐institutional studies including other US minority populations would make the findings of the current study more generalizable. In the current study, the authors perform a retrospective analysis of overall survival (OS) and progression‐free survival (PFS) among patients with non–small cell lung cancer who were treated with single‐agent immune checkpoint blockade between 2013 and 2018. The data indicate similar outcomes between Black and White patients with regard to OS, PFS, and the rate of immune‐related adverse events. Large studies are needed to make these findings more generalizable. [ABSTRACT FROM AUTHOR]