Patients with Advanced or Metastasised Non-Small-Cell Lung Cancer with L. Therapy in Addition to PD-1/PD-L1 Blockade: A Real-World Data Study.

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dc.contributor.authorSchad, Friedemann
dc.contributor.authorThronicke, Anja
dc.contributor.authorHofheinz, Ralf
dc.contributor.authorMatthes, Harald
dc.contributor.authorGrah, Christian
dc.date.accessioned2025-01-26T14:03:21Z
dc.date.available2025-01-26T14:03:21Z
dc.date.issued2024-04-22
dc.description.abstractImmunotherapy with PD-1/PD-L1 inhibitors has significantly improved the survival rates of patients with metastatic non-small-cell lung cancer (NSCLC). Results of a real-world data study investigating add-on VA ( L.) to chemotherapy have shown an association with the improved overall survival of patients with NSCLC. We sought to investigate whether the addition of VA to PD-1/PD-L1 inhibitors in patients with advanced or metastasised NSCLC would have an additional survival benefit. In the present real-world data study, we enrolled patients from the accredited national registry, Network Oncology, with advanced or metastasised NSCLC. The reporting of data was performed in accordance with the ESMO-GROW criteria for the optimal reporting of oncological real-world evidence (RWE) studies. Overall survival was compared between patients receiving PD-1/PD-L1 inhibitor therapy (control, CTRL group) versus the combination of anti-PD-1/PD-L1 therapy and VA (combination, COMB group). An adjusted multivariate Cox proportional hazard analysis was performed to investigate variables associated with survival. From 31 July 2015 to 9 May 2023, 415 patients with a median age of 68 years and a male/female ratio of 1.2 were treated with anti-PD-1/PD-L1 therapy with or without add-on VA. Survival analyses included 222 (53.5%) patients within the CRTL group and 193 (46.5%) in the COMB group. Patients in the COMB group revealed a median survival of 13.8 months and patients in the CRTL group a median survival of 6.8 months (adjusted hazard ratio, aHR: 0.60, 95% CI: 0.43-0.85, = 0.004) after adjustment for age, gender, tumour stage, BMI, ECOG status, oncological treatment, and PD-L1 tumour proportion score. A reduction in the adjusted hazard of death by 56% was seen with the addition of VA (aHR 0.44, 95% CI: 0.26-0.74, = 0.002) in patients with PD-L1-positive tumours (tumour proportion score > 1%) treated with first-line anti-PD-1/PD-L1 therapy. Our findings suggest that add-on VA correlates with improved survival in patients with advanced or metastasised NSCLC who were treated with PD-1/PD-L1 inhibitors irrespective of age, gender, tumour stage, or oncological treatment. The underlying mechanisms may include the synergistic modulation of the immune response. A limitation of this study is the observational non-randomised study design, which only allows limited conclusions to be drawn and prospective randomised trials are warranted.
dc.identifier.citationSchad, F., Thronicke, A., Hofheinz, R.-D., Matthes, H., & Grah, C. (2024). Patients with Advanced or Metastasised Non-Small-Cell Lung Cancer with Viscum album L. Therapy in Addition to PD-1/PD-L1 Blockade: A Real-World Data Study. Cancers, 16(8), Article 8. https://doi.org/10.3390/cancers16081609
dc.identifier.doihttps://doi.org/10.3390/cancers16081609
dc.identifier.issn2072-6694
dc.identifier.orcidhttps://orcid.org/0000-0002-6928-6209
dc.identifier.other38672690
dc.identifier.urihttps://hdl.handle.net/20.500.14430/755
dc.language.isoen
dc.subjectPD-1 inhibitor
dc.subjectPD-L1 inhibitor
dc.subjectViscum album L. extracts
dc.subjectlung cancer
dc.subjectnon-small-cell lung cancer
dc.subjectreal-world data study
dc.subjectsurvival
dc.titlePatients with Advanced or Metastasised Non-Small-Cell Lung Cancer with L. Therapy in Addition to PD-1/PD-L1 Blockade: A Real-World Data Study.
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleCancers (Basel)
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