Low risk of hyperprogression with first-line chemoimmunotherapy for advanced non-small cell lung cancer: pooled analysis of 7 clinical trials

Background Monotherapy immune checkpoint inhibitor (ICI) used in second- or later-line settings has been reported to induce hyperprogression. This study evaluated hyperprogression risk with ICI (atezolizumab) in the first-, second-, or later-line treatment of advanced non-small cell lung cancer (NSC...

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Autores: Li, L.X. (Lee X.)|||/items/2d3235c9-f3f5-4071-8dd8-253f80848429, Cappuzzo, F. (Federico)|||/items/29a4a118-e773-45b5-9540-6efe4d49c76e, Matos-García, I. (Ignacio)|||/items/245b22bb-7d6c-4f39-b623-c35eb8efcf30, Socinski, M.A. (Mark A.)|||/items/16bac049-5632-4209-82c2-2222b4b58785, Hopkins, A.M. (Ashley M.)|||/items/64f5afa8-8b70-4644-b89e-2aa893f05605, Sorich, M.J. (Michael J.)|||/items/964ef538-e956-474a-bd19-54a69f04d6a2
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/66059
Acceso en línea:https://hdl.handle.net/10171/66059
Access Level:acceso abierto
Palabra clave:Immune checkpoint inhibitor
Chemoimmunotherapy
Hyperprogression
Hyperprogressive disease
Non-small cell lung cancer
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spelling Low risk of hyperprogression with first-line chemoimmunotherapy for advanced non-small cell lung cancer: pooled analysis of 7 clinical trialsLi, L.X. (Lee X.)|||/items/2d3235c9-f3f5-4071-8dd8-253f80848429Cappuzzo, F. (Federico)|||/items/29a4a118-e773-45b5-9540-6efe4d49c76eMatos-García, I. (Ignacio)|||/items/245b22bb-7d6c-4f39-b623-c35eb8efcf30Socinski, M.A. (Mark A.)|||/items/16bac049-5632-4209-82c2-2222b4b58785Hopkins, A.M. (Ashley M.)|||/items/64f5afa8-8b70-4644-b89e-2aa893f05605Sorich, M.J. (Michael J.)|||/items/964ef538-e956-474a-bd19-54a69f04d6a2Immune checkpoint inhibitorChemoimmunotherapyHyperprogressionHyperprogressive diseaseNon-small cell lung cancerBackground Monotherapy immune checkpoint inhibitor (ICI) used in second- or later-line settings has been reported to induce hyperprogression. This study evaluated hyperprogression risk with ICI (atezolizumab) in the first-, second-, or later-line treatment of advanced non-small cell lung cancer (NSCLC), and provides insights into hyperprogression risk with contemporary first-line ICI treatment. Methods Hyperprogression was identified using Response Evaluation Criteria in Solid Tumours (RECIST)-based criteria in a dataset of pooled individual-participant level data from BIRCH, FIR, IMpower130, IMpower131, IMpower150, OAK, and POPLAR trials. Odds ratios were computed to compare hyperprogression risks between groups. Landmark Cox proportional-hazard regression was used to evaluate the association between hyperprogression and progression-free survival/overall survival. Secondarily, putative risk factors for hyperprogression among second- or later-line atezolizumab-treated patients were evaluated using univariate logistic regression models. Results Of the included 4644 patients, 119 of the atezolizumab-treated patients (n = 3129) experienced hyperprogression. Hyperprogression risk was markedly lower with first-line atezolizumab-either chemoimmunotherapy or monotherapy-compared to second/later-line atezolizumab monotherapy (0.7% vs. 8.8%, OR = 0.07, 95% CI, 0.04-0.13). Further, there was no statistically significant difference in hyperprogression risk with first-line atezolizumab-chemoimmunotherapy versus chemotherapy alone (0.6% vs. 1.0%, OR = 0.55, 95% CI, 0.22-1.36). Sensitivity analyses using an extended RECIST-based criteria including early death supported these findings. Hyperprogression was associated with worsened overall survival (HR = 3.4, 95% CI, 2.7-4.2, P < .001); elevated neutrophil-to-lymphocyte ratio was the strongest risk factor for hyperprogression (C-statistic = 0.62, P < .001). Conclusions This study presents first evidence for a markedly lower hyperprogression risk in advanced NSCLC patients treated with first-line ICI, particularly with chemoimmunotherapy, as compared to second- or later-line ICI treatment. This study evaluated hyperprogression risk with the use of immune checkpoint inhibitor (ICI) in the first-, second-, or later-line treatment of advanced non-small cell lung cancer, providing insight into hyperprogression risk with contemporary first-line ICI treatment.Dadun. Depósito Académico Digital Universidad de Navarra20232023-04-2020232023-01-0120232023-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10171/66059reponame:Dadun. Depósito Académico Digital de la Universidad de Navarrainstname:Universidad de NavarraInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:dadun.unav.edu:10171/660592026-06-21T12:47:57Z
dc.title.none.fl_str_mv Low risk of hyperprogression with first-line chemoimmunotherapy for advanced non-small cell lung cancer: pooled analysis of 7 clinical trials
title Low risk of hyperprogression with first-line chemoimmunotherapy for advanced non-small cell lung cancer: pooled analysis of 7 clinical trials
spellingShingle Low risk of hyperprogression with first-line chemoimmunotherapy for advanced non-small cell lung cancer: pooled analysis of 7 clinical trials
Li, L.X. (Lee X.)|||/items/2d3235c9-f3f5-4071-8dd8-253f80848429
Immune checkpoint inhibitor
Chemoimmunotherapy
Hyperprogression
Hyperprogressive disease
Non-small cell lung cancer
title_short Low risk of hyperprogression with first-line chemoimmunotherapy for advanced non-small cell lung cancer: pooled analysis of 7 clinical trials
title_full Low risk of hyperprogression with first-line chemoimmunotherapy for advanced non-small cell lung cancer: pooled analysis of 7 clinical trials
title_fullStr Low risk of hyperprogression with first-line chemoimmunotherapy for advanced non-small cell lung cancer: pooled analysis of 7 clinical trials
title_full_unstemmed Low risk of hyperprogression with first-line chemoimmunotherapy for advanced non-small cell lung cancer: pooled analysis of 7 clinical trials
title_sort Low risk of hyperprogression with first-line chemoimmunotherapy for advanced non-small cell lung cancer: pooled analysis of 7 clinical trials
dc.creator.none.fl_str_mv Li, L.X. (Lee X.)|||/items/2d3235c9-f3f5-4071-8dd8-253f80848429
Cappuzzo, F. (Federico)|||/items/29a4a118-e773-45b5-9540-6efe4d49c76e
Matos-García, I. (Ignacio)|||/items/245b22bb-7d6c-4f39-b623-c35eb8efcf30
Socinski, M.A. (Mark A.)|||/items/16bac049-5632-4209-82c2-2222b4b58785
Hopkins, A.M. (Ashley M.)|||/items/64f5afa8-8b70-4644-b89e-2aa893f05605
Sorich, M.J. (Michael J.)|||/items/964ef538-e956-474a-bd19-54a69f04d6a2
author Li, L.X. (Lee X.)|||/items/2d3235c9-f3f5-4071-8dd8-253f80848429
author_facet Li, L.X. (Lee X.)|||/items/2d3235c9-f3f5-4071-8dd8-253f80848429
Cappuzzo, F. (Federico)|||/items/29a4a118-e773-45b5-9540-6efe4d49c76e
Matos-García, I. (Ignacio)|||/items/245b22bb-7d6c-4f39-b623-c35eb8efcf30
Socinski, M.A. (Mark A.)|||/items/16bac049-5632-4209-82c2-2222b4b58785
Hopkins, A.M. (Ashley M.)|||/items/64f5afa8-8b70-4644-b89e-2aa893f05605
Sorich, M.J. (Michael J.)|||/items/964ef538-e956-474a-bd19-54a69f04d6a2
author_role author
author2 Cappuzzo, F. (Federico)|||/items/29a4a118-e773-45b5-9540-6efe4d49c76e
Matos-García, I. (Ignacio)|||/items/245b22bb-7d6c-4f39-b623-c35eb8efcf30
Socinski, M.A. (Mark A.)|||/items/16bac049-5632-4209-82c2-2222b4b58785
Hopkins, A.M. (Ashley M.)|||/items/64f5afa8-8b70-4644-b89e-2aa893f05605
Sorich, M.J. (Michael J.)|||/items/964ef538-e956-474a-bd19-54a69f04d6a2
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Dadun. Depósito Académico Digital Universidad de Navarra
dc.subject.none.fl_str_mv Immune checkpoint inhibitor
Chemoimmunotherapy
Hyperprogression
Hyperprogressive disease
Non-small cell lung cancer
topic Immune checkpoint inhibitor
Chemoimmunotherapy
Hyperprogression
Hyperprogressive disease
Non-small cell lung cancer
description Background Monotherapy immune checkpoint inhibitor (ICI) used in second- or later-line settings has been reported to induce hyperprogression. This study evaluated hyperprogression risk with ICI (atezolizumab) in the first-, second-, or later-line treatment of advanced non-small cell lung cancer (NSCLC), and provides insights into hyperprogression risk with contemporary first-line ICI treatment. Methods Hyperprogression was identified using Response Evaluation Criteria in Solid Tumours (RECIST)-based criteria in a dataset of pooled individual-participant level data from BIRCH, FIR, IMpower130, IMpower131, IMpower150, OAK, and POPLAR trials. Odds ratios were computed to compare hyperprogression risks between groups. Landmark Cox proportional-hazard regression was used to evaluate the association between hyperprogression and progression-free survival/overall survival. Secondarily, putative risk factors for hyperprogression among second- or later-line atezolizumab-treated patients were evaluated using univariate logistic regression models. Results Of the included 4644 patients, 119 of the atezolizumab-treated patients (n = 3129) experienced hyperprogression. Hyperprogression risk was markedly lower with first-line atezolizumab-either chemoimmunotherapy or monotherapy-compared to second/later-line atezolizumab monotherapy (0.7% vs. 8.8%, OR = 0.07, 95% CI, 0.04-0.13). Further, there was no statistically significant difference in hyperprogression risk with first-line atezolizumab-chemoimmunotherapy versus chemotherapy alone (0.6% vs. 1.0%, OR = 0.55, 95% CI, 0.22-1.36). Sensitivity analyses using an extended RECIST-based criteria including early death supported these findings. Hyperprogression was associated with worsened overall survival (HR = 3.4, 95% CI, 2.7-4.2, P < .001); elevated neutrophil-to-lymphocyte ratio was the strongest risk factor for hyperprogression (C-statistic = 0.62, P < .001). Conclusions This study presents first evidence for a markedly lower hyperprogression risk in advanced NSCLC patients treated with first-line ICI, particularly with chemoimmunotherapy, as compared to second- or later-line ICI treatment. This study evaluated hyperprogression risk with the use of immune checkpoint inhibitor (ICI) in the first-, second-, or later-line treatment of advanced non-small cell lung cancer, providing insight into hyperprogression risk with contemporary first-line ICI treatment.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-04-20
2023
2023-01-01
2023
2023-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10171/66059
url https://hdl.handle.net/10171/66059
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dadun. Depósito Académico Digital de la Universidad de Navarra
instname:Universidad de Navarra
instname_str Universidad de Navarra
reponame_str Dadun. Depósito Académico Digital de la Universidad de Navarra
collection Dadun. Depósito Académico Digital de la Universidad de Navarra
repository.name.fl_str_mv
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