Platinum-combination chemotherapy with or without immune-checkpoint inhibitor in patients with postoperative recurrent non-small cell lung cancer previously treated with adjuvant platinum-doublet chemotherapy: A multicenter retrospective study

Kakeru Hisakane; Takehiro Tozuka; Satoshi Takahashi; Namiko Taniuchi; Nobuhiko Nishijima; Kenichiro Atsumi; Tetsuya Okano; Masahiro Seike; Takashi Hirose

doi:10.1111/1759-7714.14992

Platinum-combination chemotherapy with or without immune-checkpoint inhibitor in patients with postoperative recurrent non-small cell lung cancer previously treated with adjuvant platinum-doublet chemotherapy: A multicenter retrospective study

Thorac Cancer. 2023 Jul;14(21):2069-2076. doi: 10.1111/1759-7714.14992. Epub 2023 Jun 8.

Authors

Kakeru Hisakane¹, Takehiro Tozuka², Satoshi Takahashi³, Namiko Taniuchi⁴, Nobuhiko Nishijima⁴, Kenichiro Atsumi¹, Tetsuya Okano³, Masahiro Seike², Takashi Hirose¹

Affiliations

¹ Department of Pulmonary Medicine and Medical Oncology, Nippon Medical School Tamanagayama Hospital, Tokyo, Japan.
² Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
³ Department of Respiratory Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan.
⁴ Department of Respiratory Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan.

Abstract

Background: Rechallenge with platinum-combination chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) after disease progression on platinum-combination chemotherapy occasionally leads to a favorable response. The efficacy and safety of platinum-combination chemotherapy with or without immune-checkpoint inhibitor (ICI) for patients with recurrent NSCLC after surgery followed by adjuvant platinum-doublet chemotherapy remains uncertain.

Methods: Patients who relapsed after surgery plus adjuvant platinum-doublet chemotherapy and received platinum-combination chemotherapy with or without ICI between April 2011 and March 2021 at four Nippon Medical School hospitals were retrospectively analyzed.

Results: Among 177 patients who received adjuvant platinum-doublet chemotherapy after surgery, a total of 30 patients who received platinum-combination rechemotherapy with or without ICI after relapse were included in this study. Seven patients received ICI-combined chemotherapy. The median disease-free survival (DFS) after surgery was 13.6 months. The objective response rate and disease-control rate were 46.7% and 80.0%, respectively. The median progression-free survival and overall survival were 10.2 and 37.5 months, respectively. Patients with longer DFS (≥12 months) had a better prognosis than others. The most common grade ≥3 toxicity associated with this treatment was neutropenia (33%). Grade ≥3 immune-related adverse events were pneumonitis (14%) and colitis (14%). Treatment-related deaths did not occur in this study.

Conclusion: Platinum-combination chemotherapy with or without ICI for patients with postoperative recurrent NSCLC who previously received adjuvant platinum-doublet chemotherapy was effective and safe. In particular, this therapy may be promising for patients with longer DFS.

Keywords: immune-checkpoint inhibitor; non-small cell lung cancer; platinum-combination chemotherapy; postoperative recurrence.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Carcinoma, Non-Small-Cell Lung* / drug therapy
Carcinoma, Non-Small-Cell Lung* / etiology
Carcinoma, Non-Small-Cell Lung* / surgery
Humans
Immune Checkpoint Inhibitors / therapeutic use
Lung Neoplasms* / drug therapy
Lung Neoplasms* / etiology
Lung Neoplasms* / surgery
Neoplasm Recurrence, Local / drug therapy
Neoplasm Recurrence, Local / etiology
Platinum / pharmacology
Platinum / therapeutic use
Retrospective Studies

Substances

Platinum
Immune Checkpoint Inhibitors