Real-world experience with anti-PD-1/PD-L1 monotherapy in patients with non-small cell lung cancer

As real-world data regarding immunotherapy for non-small cell lung cancer are lacking for Austria, we conducted a retrospective study in six hospitals to present data from real-world practice.

Patients with metastatic non-small cell lung cancer were stratified into two groups, either patients with first-line pembrolizumab monotherapy (cohort 1) or patients with second-line nivolumab, pembrolizumab or atezolizumab monotherapy (cohort 2). Primary outcome measures were objective response rate and overall survival. A matched-pair analysis was performed to compare overall survival to patients from the Tyrolean Lung Cancer Project as a historical control group.

In total, 89 patients were identified, 42 patients in cohort 1 and 47 patients in cohort 2. The objective response rates were 43.3% and 31.4%, respectively. The median overall survival was 17.0 months (95% CI 11.7–21.5 months) in cohort 1 and 18.7 months (95% CI 9.5–23.4 months) in cohort 2. Treatment-related adverse events grades 3 and 4 were reported in 11.2% of patients. The matched-pair analysis showed a median overall survival of 15.2 months (95% CI 7.6–20.4 months) for first-line pembrolizumab monotherapy compared to 9.8 months (95% CI 7.8–11.6 months) for the historical control (p = 0.43). In cohort 2, a median overall survival of 20.3 months (95% CI 6.9–26.2 months) for second-line immunotherapy compared to 5.4 months (95% CI 3.2–11.7 months) for the historical control (p = 0.18) was shown.

The results are comparable with other real-world studies and, when matched to historical controls, support the improvement in outcomes made possible by these agents.