Pleural or pericardial metastasis: A significant factor affecting efficacy and adverse events in lung cancer patients treated with PD‐1/PD‐L1 inhibitors

• Published in: Thoracic cancer Vol. 9; no. 11; pp. 1500 - 1508
• Main Authors: Kang, Da Hyun, Chung, Chaeuk, Kim, Ju‐Ock, Jung, Sung Soo, Park, Hee Sun, Park, Dong Il, Jung, Sun Young, Park, Myoungrin, Lee, Jeong Eun
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.11.2018; John Wiley & Sons, Inc
• Subjects: Adverse event; Biomarkers; Cancer; Cancer patients; Cancer therapies; Chemotherapy; Complications and side effects; Drug dosages; Drug therapy; Humans; immune checkpoint inhibitor; Immunotherapy; Immunotherapy - adverse effects; Immunotherapy - methods; Lung cancer; Lung cancer, Non-small cell; Lung Neoplasms - complications; Lung Neoplasms - drug therapy; Lymphocytes; Medical prognosis; Medical records; Melanoma; Metastasis; Middle Aged; Mutation; Neoplasm Metastasis; non‐small cell lung cancer; Original; Patients; pericardial metastasis; pleural metastasis; Programmed Cell Death 1 Receptor - antagonists & inhibitors; Studies; Tumors; United States > US; non-small cell lung cancer; Adverse event; pleural metastasis; immune checkpoint inhibitor; pericardial metastasis
• ISSN: 1759-7706; 1759-7714
• DOI: 10.1111/1759-7714.12877

Background Immunotherapy is a new paradigm for the treatment of non‐small‐cell lung cancer (NSCLC), and targeting the PD‐1 or PD‐L1 pathway is a promising therapeutic option. Although PD‐1/PD‐L1 inhibitors are more effective than standard chemotherapy in lung cancer, clinicians are afraid to actively use them because of hyperprogression and pseudoprogression. The aim of this study was to investigate the factors associated with tumor response and serious outcomes. Methods We retrospectively collected the medical records of 51 patients with advanced NSCLC who received PD‐1/PD‐L1 inhibitors between January 2016 and February 2018. Results The mean patient age was 63.9 years, and 72.5% (37/51) were male. Most (92.2%, 47/51) had received previous systemic treatment. The overall response rate was 21.6% (11/51). The response rate was significantly lower in patients with pleural or pericardial metastasis than in patients without pleural or pericardial metastasis (4.3% vs. 35.7%; P = 0.007). Patients with pleural or pericardial metastasis had a significantly higher rate of adverse events of any grade (91.3% vs. 50.0%; P = 0.002) and grade 3–5 adverse events (52.2% vs. 25.0%; P = 0.046). Conclusion Pleural or pericardial metastasis is a significant factor affecting the efficacy and rate of adverse events in advanced NSCLC patients treated with PD‐1/PD‐L1 inhibitors. Clinicians should pay attention to the use of immune checkpoint inhibitors in lung cancer patients with pleural or pericardial metastasis.