RT Journal Article
SR Electronic
T1 A Multivariable Regression Model-based Nomogram for Estimating the Overall Survival of Patients Previously Treated With Nivolumab for Advanced Non-small-cell Lung Cancer
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 4229
OP 4236
DO 10.21873/anticanres.14424
VO 40
IS 8
A1 TAMIYA, AKIHIRO
A1 TAMIYA, MOTOHIRO
A1 GO, HIROFUMI
A1 INOUE, TAKAKO
A1 KUNIMASA, KEI
A1 NAKAHAMA, KENJI
A1 TANIGUCHI, YOSHIHIKO
A1 SHIROYAMA, TAKAYUKI
A1 ISA, SHUN-ICHI
A1 NISHINO, KAZUMI
A1 KUMAGAI, TORU
A1 SUZUKI, HIDEKAZU
A1 HIRASHIMA, TOMONORI
A1 ATAGI, SHINJI
A1 SHINTANI, AYUMI
A1 IMAMURA, FUMIO
YR 2020
UL http://ar.iiarjournals.org/content/40/8/4229.abstract
AB Aim: Although nivolumab improves progression-free (PFS) and overall (OS) survival of patients previously treated for metastatic non-small-cell lung cancer (NSCLC), approximately 50% of treated patients experience disease progression within 3 months. As predictive biomarkers of response are not yet established, development of biomarkers to predict longer PFS and OS of patients treated with nivolumab is crucial. Therefore, we analyzed the impact of predictive markers of response to nivolumab and quantified the impact of each factor using nomograms. Patients and Methods: Clinical data at nivolumab commencement were retrospectively collected from 201 patients treated with nivolumab between December 2015 and July 2016. Immunohistochemistry for programmed cell death ligand 1 (PD-L1) was performed using two assay systems (22C3 and 28-8). OS was calculated from nivolumab treatment initiation. Multivariate Cox regression analysis was conducted to identify independent predictors of OS. A nomogram was constructed to estimate OS. Results: The median patient age was 68 years (135 males). Thirty-nine patients had driver mutations (epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangement). In 22C3 and 28-8 immunostaining assays, 36.3% and 36.8% patients had PD-L1-negative cells, 17.4% and 14.4% had 1-49% PD-L1-positive cells, 11.9% and 14.9% had ≥50% PD-L1-positive cells, and 34.3% and 33.8% had unknown PD-L1 status, respectively. Kendall's rank correlation coefficient between the staining assays was 0.8414. The median OS of the whole patient cohort was 12.27 months [95% confidence interval (CI)=10.87-15.6]. Performance status ≥2 [hazard ratio (HR)=2.15, 95% CI=1.35-3.42, p=0.001) and high baseline lactate dehydrogenase (HR=1.15, 95% CI=1.05-1.26, p=0.004] were independent predictors of shorter OS. There was no significant correlation between PD-L1 status and OS. We constructed a nomogram to estimate the OS of patients previously treated with nivolumab. Conclusion: The multivariate analysis-based nomogram might be useful to estimate the OS of patients previously treated with nivolumab for advanced NSCLC.