Background Improved outcome in tobacco smoking patients with non-small cell lung cancer (NSCLC) following immunotherapy has previously been reported. However, little is known regarding this association during first-line immunotherapy in patients with high PD-L1 expression. In this study we compared clinical outcomes according to the smoking status of two large multicenter cohorts.Methods We compared clinical outcomes according to the smoking status (never smokers vs. current/former smokers) of two retrospective multicenter cohorts of metastatic NSCLC patients, treated with first-line pembrolizumab and platinum-based chemotherapy.Results A total of 962 NSCLC patients with PD-L1 expression >= 50% who received first-line pembrolizumab and 462 NSCLC patients who received first-line platinum-based chemotherapy were included in the study. Never smokers were confirmed to have a significantly higher risk of disease progression (hazard ratio [HR] = 1.49 [95% CI: 1.15-1.92], p = 0.0022) and death (HR = 1.38 [95% CI: 1.02-1.87], p = 0.0348) within the pembrolizumab cohort. On the contrary, a nonsignificant trend towards a reduced risk of disease progression (HR = 0.74 [95% CI: 0.52-1.05], p = 0.1003) and death (HR = 0.67 [95% CI: 0.45-1.01], p = 0.0593) were reported for never smokers within the chemotherapy cohort. After a random case-control matching, 424 patients from both cohorts were paired. Within the matched pembrolizumab cohort, never smokers had a significantly shorter progression-free survival (PFS) (HR = 1.68 [95% CI: 1.17-2.40], p = 0.0045) and a nonsignificant trend towards a shortened overall survival (OS) (HR = 1.32 [95% CI: 0.84-2.07], p = 0.2205). On the contrary, never smokers had a significantly longer PFS (HR = 0.68 [95% CI: 0.49-0.95], p = 0.0255) and OS (HR = 0.66 [95% CI: 0.45-0.97], p = 0,0356) compared to current/former smoker patients within the matched chemotherapy cohort. On pooled multivariable analysis, the interaction term between smoking status and treatment modality was concordantly statistically significant with respect to ORR (p = 0.0074), PFS (p = 0.0001) and OS (p = 0.0020), confirming the significantly different impact of smoking status across the two cohorts.Conclusions Among metastatic NSCLC patients with PD-L1 expression >= 50% receiving first-line pembrolizumab, current/former smokers experienced improved PFS and OS. On the contrary, worse outcomes were reported among current/former smokers receiving first-line chemotherapy.

Smoking status during first-line immunotherapy and chemotherapy in NSCLC patients: A case-control matched analysis from a large multicenter study / Cortellini, Alessio; De Giglio, Andrea; Cannita, Katia; Cortinovis, Diego L; Cornelissen, Robin; Baldessari, Cinzia; Giusti, Raffaele; D'Argento, Ettore; Grossi, Francesco; Santoni, Matteo; Catino, Annamaria; Berardi, Rossana; Sforza, Vincenzo; Rossi, Giovanni; Antonuzzo, Lorenzo; Di Noia, Vincenzo; Signorelli, Diego; Gelibter, Alain; Occhipinti, Mario Alberto; Follador, Alessandro; Rastelli, Francesca; Chiari, Rita; Gravara, Luigi Della; Inno, Alessandro; De Tursi, Michele; Di Marino, Pietro; Mansueto, Giovanni; Zoratto, Federica; Filetti, Marco; Montrone, Michele; Citarella, Fabrizio; Pensieri, Maria Vittoria; Russano, Marco; Cantini, Luca; Nigro, Olga; Leonetti, Alessandro; Bordi, Paola; Minuti, Gabriele; Landi, Lorenza; De Toma, Alessandro; Donisi, Clelia; Ricciardi, Serena; Migliorino, Maria Rita; Napoli, Valerio Maria; Leone, Gianmarco; Metro, Giulio; Banna, Giuseppe L; Friedlaender, Alex; Addeo, Alfredo; Ficorella, Corrado; Porzio, Giampiero. - In: THORACIC CANCER. - ISSN 1759-7706. - STAMPA. - 12:(2021), pp. 880-889. [10.1111/1759-7714.13852]

Smoking status during first-line immunotherapy and chemotherapy in NSCLC patients: A case-control matched analysis from a large multicenter study

Antonuzzo, Lorenzo;
2021

Abstract

Background Improved outcome in tobacco smoking patients with non-small cell lung cancer (NSCLC) following immunotherapy has previously been reported. However, little is known regarding this association during first-line immunotherapy in patients with high PD-L1 expression. In this study we compared clinical outcomes according to the smoking status of two large multicenter cohorts.Methods We compared clinical outcomes according to the smoking status (never smokers vs. current/former smokers) of two retrospective multicenter cohorts of metastatic NSCLC patients, treated with first-line pembrolizumab and platinum-based chemotherapy.Results A total of 962 NSCLC patients with PD-L1 expression >= 50% who received first-line pembrolizumab and 462 NSCLC patients who received first-line platinum-based chemotherapy were included in the study. Never smokers were confirmed to have a significantly higher risk of disease progression (hazard ratio [HR] = 1.49 [95% CI: 1.15-1.92], p = 0.0022) and death (HR = 1.38 [95% CI: 1.02-1.87], p = 0.0348) within the pembrolizumab cohort. On the contrary, a nonsignificant trend towards a reduced risk of disease progression (HR = 0.74 [95% CI: 0.52-1.05], p = 0.1003) and death (HR = 0.67 [95% CI: 0.45-1.01], p = 0.0593) were reported for never smokers within the chemotherapy cohort. After a random case-control matching, 424 patients from both cohorts were paired. Within the matched pembrolizumab cohort, never smokers had a significantly shorter progression-free survival (PFS) (HR = 1.68 [95% CI: 1.17-2.40], p = 0.0045) and a nonsignificant trend towards a shortened overall survival (OS) (HR = 1.32 [95% CI: 0.84-2.07], p = 0.2205). On the contrary, never smokers had a significantly longer PFS (HR = 0.68 [95% CI: 0.49-0.95], p = 0.0255) and OS (HR = 0.66 [95% CI: 0.45-0.97], p = 0,0356) compared to current/former smoker patients within the matched chemotherapy cohort. On pooled multivariable analysis, the interaction term between smoking status and treatment modality was concordantly statistically significant with respect to ORR (p = 0.0074), PFS (p = 0.0001) and OS (p = 0.0020), confirming the significantly different impact of smoking status across the two cohorts.Conclusions Among metastatic NSCLC patients with PD-L1 expression >= 50% receiving first-line pembrolizumab, current/former smokers experienced improved PFS and OS. On the contrary, worse outcomes were reported among current/former smokers receiving first-line chemotherapy.
2021
12
880
889
Cortellini, Alessio; De Giglio, Andrea; Cannita, Katia; Cortinovis, Diego L; Cornelissen, Robin; Baldessari, Cinzia; Giusti, Raffaele; D'Argento, Ettore; Grossi, Francesco; Santoni, Matteo; Catino, Annamaria; Berardi, Rossana; Sforza, Vincenzo; Rossi, Giovanni; Antonuzzo, Lorenzo; Di Noia, Vincenzo; Signorelli, Diego; Gelibter, Alain; Occhipinti, Mario Alberto; Follador, Alessandro; Rastelli, Francesca; Chiari, Rita; Gravara, Luigi Della; Inno, Alessandro; De Tursi, Michele; Di Marino, Pietro; Mansueto, Giovanni; Zoratto, Federica; Filetti, Marco; Montrone, Michele; Citarella, Fabrizio; Pensieri, Maria Vittoria; Russano, Marco; Cantini, Luca; Nigro, Olga; Leonetti, Alessandro; Bordi, Paola; Minuti, Gabriele; Landi, Lorenza; De Toma, Alessandro; Donisi, Clelia; Ricciardi, Serena; Migliorino, Maria Rita; Napoli, Valerio Maria; Leone, Gianmarco; Metro, Giulio; Banna, Giuseppe L; Friedlaender, Alex; Addeo, Alfredo; Ficorella, Corrado; Porzio, Giampiero
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1287133
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