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Survival of patients with non-small cell lung cancer having leptomeningeal metastases treated with immune checkpoint inhibitors.
Eur J Cancer 2019; 116:182-189EJ

Abstract

INTRODUCTION

Patients with non-small cell lung cancer (NSCLC) experience leptomeningeal metastases (LM) in 3-9% of cases. Because overall survival (OS) and performance status are very poor, they are mostly excluded from clinical trials. Here, we evaluated survival of patients with NSCLC having LM treated with immune checkpoint inhibitors (ICIs).

METHODS

A prospectively collected list of patients with advanced NSCLC treated with ICIs between November 2012 and July 2018 in 7 European centres was merged. All patients with LM before ICI start were selected, data were retrospectively added and patients were classified according to the National Comprehensive Cancer Network (NCCN) LM prognostic classification (good/poor). Progression-free survival (PFS) and OS on ICIs were evaluated.

RESULTS

Nineteen of 1288 (1.5%) patients had LM; 73.7% had synchronous brain metastases; 73.7% had neurological symptoms at the start of ICIs and 52.6% were in the NCCN LM good prognosis group. Programmed death ligand-1 (PD-L1) expression was known for 42.1% of patients (87.5% positive). Median follow-up was 13 months from the start of ICIs, and median (95% confidence interval [CI]) PFS on ICIs was 2.0 (1.8-2.2) months. Six-month PFS rate was 21.0% and was significantly higher in the NCCN good versus poor prognostic group: 40% vs 0% (p = 0.05). Twelve-month PFS rate was 0%. Median (95% CI) OS from the start of ICIs was 3.7 (0.9-6.6) months. Six-month OS rate was 36.8%, and 12-month OS rate was 21.1%; both were not statistically significantly different for the good versus poor NCCN prognostic group (p = 0.40 and p = 0.56, respectively).

CONCLUSION

Some patients with NSCLC having LM do benefit from ICI treatment; specifically, those in the NCCN LM good prognosis group can obtain a long survival.

Authors+Show Affiliations

Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France; Department of Pulmonary Diseases, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands. Electronic address: lizza.hendriks@mumc.nl.Department of Pulmonary Diseases, Zuyderland Hospital, Location Heerlen, the Netherlands. Electronic address: G.bootsma@zuyderland.nl.Department of Pulmonary Diseases, Centre Hospitalier Universitaire de Toulouse, Université Paul Sabatier, Toulouse, France. Electronic address: Jean.mourlanette@orange.fr.Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France. Electronic address: clemence.HENON@gustaveroussy.fr.Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France. Electronic address: laura.MEZQUITA@gustaveroussy.fr.Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France. Electronic address: Roberto.Ferrara@istitutotumori.mi.it.Department of Pulmonary Diseases, Centre Hospitalier Toulon Sainte-Musse, Toulon, France. Electronic address: Clarisse.Audigier-Valette@ch-toulon.fr.Department of Pulmonary Diseases, Centre Hospitalier Universitaire de Toulouse, Université Paul Sabatier, Toulouse, France. Electronic address: mazieres.j@chu-toulouse.fr.Department of Pulmonary Diseases, Centre Hospitalier Universitaire de Toulouse, Université Paul Sabatier, Toulouse, France. Electronic address: corentin.lefebvre@hotmail.com.Department of Pulmonary Diseases, Hopital Avicenne, Paris, France. Electronic address: Boris.duchemann@aphp.fr.Department of Medical Oncology, Institut Bergonie, Bordeaux, France. Electronic address: s.cousin@bordeaux.unicancer.fr.Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France. Electronic address: Cecile.LEPECHOUX@gustaveroussy.fr.Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France. Electronic address: angela.BOTTICELLA@gustaveroussy.fr.Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands. Electronic address: Dirk.deruysscher@maastro.nl.Department of Pulmonary Diseases, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands. Electronic address: a.dingemans@mumc.nl.Department of Medical Oncology, Gustave Roussy Cancer Campus, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France; Paris-Sud University, Orsay, France. Electronic address: Benjamin.BESSE@gustaveroussy.fr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31203193

Citation

Hendriks, Lizza E L., et al. "Survival of Patients With Non-small Cell Lung Cancer Having Leptomeningeal Metastases Treated With Immune Checkpoint Inhibitors." European Journal of Cancer (Oxford, England : 1990), vol. 116, 2019, pp. 182-189.
Hendriks LEL, Bootsma G, Mourlanette J, et al. Survival of patients with non-small cell lung cancer having leptomeningeal metastases treated with immune checkpoint inhibitors. Eur J Cancer. 2019;116:182-189.
Hendriks, L. E. L., Bootsma, G., Mourlanette, J., Henon, C., Mezquita, L., Ferrara, R., ... Besse, B. (2019). Survival of patients with non-small cell lung cancer having leptomeningeal metastases treated with immune checkpoint inhibitors. European Journal of Cancer (Oxford, England : 1990), 116, pp. 182-189. doi:10.1016/j.ejca.2019.05.019.
Hendriks LEL, et al. Survival of Patients With Non-small Cell Lung Cancer Having Leptomeningeal Metastases Treated With Immune Checkpoint Inhibitors. Eur J Cancer. 2019;116:182-189. PubMed PMID: 31203193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survival of patients with non-small cell lung cancer having leptomeningeal metastases treated with immune checkpoint inhibitors. AU - Hendriks,Lizza E L, AU - Bootsma,Gerben, AU - Mourlanette,Jean, AU - Henon,Clemence, AU - Mezquita,Laura, AU - Ferrara,Roberto, AU - Audigier-Valette,Clarisse, AU - Mazieres,Julien, AU - Lefebvre,Corentin, AU - Duchemann,Boris, AU - Cousin,Sophie, AU - le Pechoux,Cecile, AU - Botticella,Angela, AU - De Ruysscher,Dirk, AU - Dingemans,Anne-Marie C, AU - Besse,Benjamin, Y1 - 2019/06/13/ PY - 2019/03/15/received PY - 2019/05/04/revised PY - 2019/05/12/accepted PY - 2019/6/17/pubmed PY - 2019/6/17/medline PY - 2019/6/17/entrez KW - Immune checkpoint inhibition KW - Leptomeningeal metastases KW - NSCLC SP - 182 EP - 189 JF - European journal of cancer (Oxford, England : 1990) JO - Eur. J. Cancer VL - 116 N2 - INTRODUCTION: Patients with non-small cell lung cancer (NSCLC) experience leptomeningeal metastases (LM) in 3-9% of cases. Because overall survival (OS) and performance status are very poor, they are mostly excluded from clinical trials. Here, we evaluated survival of patients with NSCLC having LM treated with immune checkpoint inhibitors (ICIs). METHODS: A prospectively collected list of patients with advanced NSCLC treated with ICIs between November 2012 and July 2018 in 7 European centres was merged. All patients with LM before ICI start were selected, data were retrospectively added and patients were classified according to the National Comprehensive Cancer Network (NCCN) LM prognostic classification (good/poor). Progression-free survival (PFS) and OS on ICIs were evaluated. RESULTS: Nineteen of 1288 (1.5%) patients had LM; 73.7% had synchronous brain metastases; 73.7% had neurological symptoms at the start of ICIs and 52.6% were in the NCCN LM good prognosis group. Programmed death ligand-1 (PD-L1) expression was known for 42.1% of patients (87.5% positive). Median follow-up was 13 months from the start of ICIs, and median (95% confidence interval [CI]) PFS on ICIs was 2.0 (1.8-2.2) months. Six-month PFS rate was 21.0% and was significantly higher in the NCCN good versus poor prognostic group: 40% vs 0% (p = 0.05). Twelve-month PFS rate was 0%. Median (95% CI) OS from the start of ICIs was 3.7 (0.9-6.6) months. Six-month OS rate was 36.8%, and 12-month OS rate was 21.1%; both were not statistically significantly different for the good versus poor NCCN prognostic group (p = 0.40 and p = 0.56, respectively). CONCLUSION: Some patients with NSCLC having LM do benefit from ICI treatment; specifically, those in the NCCN LM good prognosis group can obtain a long survival. SN - 1879-0852 UR - https://www.unboundmedicine.com/medline/citation/31203193/Survival_of_patients_with_non-small_cell_lung_cancer_having_leptomeningeal_metastases_treated_with_immune_checkpoint_inhibitors L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-8049(19)30322-3 DB - PRIME DP - Unbound Medicine ER -