2023 World Conference on Lung Cancer (Posters)-EP13.05. Effects and Outcomes Analysis of Immunotherapy for Patients with Pulmonary Large-Cell Neuroendocrine Carcinoma

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This study analyzed the effects and outcomes of immunotherapy for patients with pulmonary large-cell neuroendocrine carcinoma (LCNEC). The study included 45 patients who were diagnosed with LCNEC and were in stage IIIB-IV according to the TNM staging system. The patients had received at least two cycles of chemotherapy or a combination of immunotherapy and chemotherapy (ICIChemo). The study compared the outcomes between patients who received ICIChemo and those who received chemotherapy alone.<br /><br />The results showed that ICIChemo had a higher overall response rate (ORR) compared to chemotherapy alone (42% vs. 18%). However, this difference was not statistically significant. The disease control rate (DCR) was higher in the ICIChemo group compared to the chemotherapy group (95.0% vs. 73%), but again, this difference was not statistically significant. The median progression-free survival (PFS) was similar in both groups (6.3 months in the ICIChemo group vs. 6.4 months in the chemotherapy group), as was the median overall survival (OS) (14.5 months in the ICIChemo group vs. 22.0 months in the chemotherapy group).<br /><br />The study also analyzed the effects of different chemotherapy regimens and found no significant difference in PFS between etoposide/cisplatin (EC) and other chemotherapy regimens. Similarly, there was no significant difference in PFS between atezolizumab and durvalumab. <br /><br />In the subgroup analysis, for patients who were negative for PD-L1, chemotherapy alone had better PFS compared to ICIChemo (median PFS: 11.0 months vs. 4.9 months). For PD-L1 positive or not available patients, PFS was better with ICIChemo (median PFS: 5.8 months vs. 8.1 months). <br /><br />The study also found a trend towards a PFS benefit from ICIChemo for patients with brain metastases. There was no significant effect of TP53 mutation on the efficacy of treatment. However, a level of CYFRA21-1 below 3.5ng/ml was found to be an independent predictor for better PFS in the ICIChemo group. <br /><br />In conclusion, the study suggests that ICIChemo may have a higher response rate and disease control rate compared to chemotherapy alone, although the difference was not statistically significant. The choice of treatment may depend on PD-L1 status and the presence of brain metastases. Further research is needed to better understand the effects of immunotherapy in LCNEC patients.

Asset Subtitle

Tianqing Chu

Meta Tag

Speaker Tianqing Chu

Topic SCLC & Neuroendocrine Tumors: NETs

Keywords

immunotherapy

pulmonary large-cell neuroendocrine carcinoma

LCNEC

TNM staging system

chemotherapy

ICIChemo

overall response rate

disease control rate

progression-free survival

overall survival