{"id":11072,"date":"2022-07-14T00:13:21","date_gmt":"2022-07-13T23:13:21","guid":{"rendered":"https:\/\/www.gecp.pt\/?p=11072"},"modified":"2022-07-15T10:50:55","modified_gmt":"2022-07-15T09:50:55","slug":"artigo-escolhido-14-jul-2022","status":"publish","type":"post","link":"https:\/\/www.gecp.pt\/en\/artigo-escolhido-14-jul-2022\/","title":{"rendered":"Chosen Article"},"content":{"rendered":"

<\/p>\n\n\n\n

Dr. Fernanda Estevinho
Oncologist at Hospital Pedro Hispano \u2013 ULS Matosinhos
Selected Article: “Effectiveness of PD-(L)1 inhibitors alone or in combination with platinum doublet chemotherapy in first-line (1L) non-squamous non-small-cell lung cancer (Nsq-NSCLC) with PD-L1-high expression using real-world data”<\/p>\n\n\n\n

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O artigo selecionado foi: \u201cEffectiveness of PD-(L)1 inhibitors alone or in combination with platinum doublet chemotherapy in first-line (1L) non-squamous non-small-cell lung cancer (Nsq-NSCLC) with PD-L1-high expression using real-world data\u201d, publicado na revista Annals of Oncology<\/em> em maio, e que tem como autor principal o Professor Maurcie P\u00e9rol.<\/p>\n\n\n\n

Este estudo de vida real avaliou o tratamento de 1\u00aa linha de doentes com cancro do pulm\u00e3o de n\u00e3o pequenas-c\u00e9lulas, n\u00e3o-escamoso, metastizado e express\u00e3o de PD-L1 50% com inibidor do checkpoint imunit\u00e1rio (ICI) em monoterapia versus <\/em>a associa\u00e7\u00e3o de inibidor do checkpoint imunit\u00e1rio a quimioterapia com dupleto de platino.<\/p>\n\n\n\n

\u00c9 um estudo retrospetivo, que incluiu doentes da base de dados United States Flatiron Health electronic health record<\/em>, dos EUA, que iniciaram o tratamento entre 24 de outubro de 2016 e 28 de fevereiro de 2019. Foram inclu\u00eddos 351 doentes que realizaram tratamento com ICI em monoterapia e 169 com a combina\u00e7\u00e3o. Todos apresentavam capacidade funcional ECOG 0-1. Foram exclu\u00eddos doentes com muta\u00e7\u00f5es do gene EGFR, rearranjo ALK, ROS-1, ou muta\u00e7\u00e3o BRAF.<\/p>\n\n\n\n

De real\u00e7ar que a amostra de doentes tratados com ICI em monoterapia inclu\u00eda doentes mais velhos (31% < 65 anos e 37%  75 anos versus <\/em>46% < 65 anos e 20% anos; p < 0.001) e menos doentes com diagn\u00f3stico de novo<\/em> de cancro do pulm\u00e3o (77% versus<\/em> 93%; p < 0.001).<\/p>\n\n\n\n

A sobreviv\u00eancia global (endpoint<\/em> principal) e sobreviv\u00eancia livre de progress\u00e3o no mundo real (endpoint <\/em>secund\u00e1rio) foram calculadas pelo m\u00e9todo de Kaplan-Meier e n\u00e3o apresentaram diferen\u00e7as estatisticamente significativas, exceto no subgrupo dos n\u00e3o fumadores.<\/p>\n\n\n\n

No que se refere \u00e0 sobreviv\u00eancia livre de progress\u00e3o foi de 11,5m no grupo de tratamento com ICI em monoterapia e de 10,8m no grupo da combina\u00e7\u00e3o (aHR:1,04; IC95 %: 0,78-1,37; p=0,81). A sobreviv\u00eancia global foi 22,1m no grupo da monoterapia e 21,0m no grupo da combina\u00e7\u00e3o (aHR:1,03; IC95%: 0,77-1,39; p=0,83).<\/p>\n\n\n\n

No subgrupo de n\u00e3o fumadores verificou-se que o tratamento com a combina\u00e7\u00e3o associou-se a melhoria da sobreviv\u00eancia global (HR 0,25; IC95%:0,07-0,83) e da sobreviv\u00eancia livre de progress\u00e3o (HR 0,40; IC 95%: 0,17-0,95; p=0.04).<\/p>\n\n\n\n

N\u00e3o foram encontradas diferen\u00e7as estatisticamente significativas para o endpoint <\/em>principal e secund\u00e1rio nos subgrupos de doentes com metastiza\u00e7\u00e3o cerebral ou hep\u00e1tica.<\/p>\n\n\n\n

Como coment\u00e1rio final, real\u00e7o que se aguardam resultados dos ensaios cl\u00ednicos randomizados em curso comparando estas duas estrat\u00e9gias terap\u00eauticas de 1.\u00aa linha, e ser\u00e1 essencial o estudo do subgrupo de doentes n\u00e3o fumadores.<\/p>\n\n\n\n

Link direto para o estudo.<\/a><\/p>\n\n\n\n

The selected article was: \u201cEffectiveness of PD-(L)1 inhibitors alone or in combination with platinum doublet chemotherapy in first-line (1L) non-squamous non-small-cell lung cancer (Nsq-NSCLC) with PD-L1- high expression using real-world data\u201d, published in the Annals of Oncology magazine in May, and whose main author is Professor Maurcie P\u00e9rol.<\/p>\n\n\n\n

This real-life study evaluated first-line treatment of patients with metastatic, non-squamous, non-small cell lung cancer and PD-L1 expression \u2265 50% with immune checkpoint inhibitor (ICI) alone versus the combination. from immune checkpoint inhibitor to platinum doublet chemotherapy.<\/p>\n\n\n\n

It is a retrospective study, which included patients from the United States Flatiron Health electronic health record database, USA, who started treatment between October 24, 2016 and February 28, 2019. We included 351 patients who underwent treatment with ICI in monotherapy and 169 with the combination. All had ECOG 0-1 functional capacity. Patients with EGFR gene mutations, ALK rearrangement, ROS-1, or BRAF mutation were excluded.
It should be noted that the sample of patients treated with ICI alone included older patients (31% < 65 years and 37% \u2265 75 years versus 46% < 65 years and 20% \u226575 years; p < 0.001) and fewer patients diagnosed de novo lung cancer (77% versus 93%; p < 0.001).<\/p>\n\n\n\n

Overall survival (primary endpoint) and real-world progression-free survival (secondary endpoint) were calculated using the Kaplan-Meier method and did not show statistically significant differences, except in the non-smokers subgroup.<\/p>\n\n\n\n

Progression-free survival was 11.5 m in the ICI monotherapy treatment group and 10.8 m in the combination group (aHR: 1.04; 95% CI: 0.78-1.37; p =0.81). Overall survival was 22.1m in the monotherapy group and 21.0m in the combination group (aHR:1.03; 95%CI: 0.77-1.39; p=0.83).<\/p>\n\n\n\n

In the non-smoking subgroup, treatment with the combination was found to be associated with improved overall survival (HR 0.25; 95%CI: 0.07-0.83) and progression-free survival (HR 0.40). ; 95% CI: 0.17-0.95; p=0.04).<\/p>\n\n\n\n

No statistically significant differences were found for the primary and secondary endpoint in the subgroups of patients with brain or liver metastases.<\/p>\n\n\n\n

As a final comment, I emphasize that the results of the ongoing randomized clinical trials comparing these two first-line therapeutic strategies are awaited, and the study of the subgroup of non-smoking patients will be essential.<\/p>\n\n\n\n

Direct link to the study<\/a><\/p>\n\n

\n <\/div>\n\n","protected":false},"excerpt":{"rendered":"

Dr. Fernanda EstevinhoOncologist at Hospital Pedro Hispano \u2013 ULS MatosinhosSelected Article: “Effectiveness of PD-(L)1 inhibitors alone or in combination with platinum doublet chemotherapy in first-line (1L) non-squamous non-small-cell lung cancer (Nsq-NSCLC) with PD-L1-high expression using real-world data” O artigo selecionado…<\/p>","protected":false},"author":1,"featured_media":11096,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"ngg_post_thumbnail":0},"categories":[187,118],"tags":[],"_links":{"self":[{"href":"https:\/\/www.gecp.pt\/en\/wp-json\/wp\/v2\/posts\/11072"}],"collection":[{"href":"https:\/\/www.gecp.pt\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.gecp.pt\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.gecp.pt\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.gecp.pt\/en\/wp-json\/wp\/v2\/comments?post=11072"}],"version-history":[{"count":12,"href":"https:\/\/www.gecp.pt\/en\/wp-json\/wp\/v2\/posts\/11072\/revisions"}],"predecessor-version":[{"id":11099,"href":"https:\/\/www.gecp.pt\/en\/wp-json\/wp\/v2\/posts\/11072\/revisions\/11099"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.gecp.pt\/en\/wp-json\/wp\/v2\/media\/11096"}],"wp:attachment":[{"href":"https:\/\/www.gecp.pt\/en\/wp-json\/wp\/v2\/media?parent=11072"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.gecp.pt\/en\/wp-json\/wp\/v2\/categories?post=11072"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.gecp.pt\/en\/wp-json\/wp\/v2\/tags?post=11072"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}