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dc.contributor.authorTomasik, B
dc.contributor.authorBieńkowski, M
dc.contributor.authorBraun, M
dc.contributor.authorPopat, S
dc.contributor.authorDziadziuszko, R
dc.date.accessioned2021-10-20T09:33:32Z
dc.date.available2021-10-20T09:33:32Z
dc.identifier.citationLung cancer (Amsterdam, Netherlands), 2021, 158 pp. 97 - 106en_US
dc.identifier.issn0169-5002
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/4833
dc.identifier.eissn1872-8332en_US
dc.identifier.eissn1872-8332
dc.identifier.doi10.1016/j.lungcan.2021.06.004en_US
dc.identifier.doi10.1016/j.lungcan.2021.06.004
dc.description.abstract<h4>Background</h4>Immune checkpoint inhibitors (ICIs) are standard of care in advanced non-small cell lung cancer (NSCLC), however their status in patients with poor performance status (PS) is poorly defined. We aimed to evaluate the efficacy and safety of ICIs in NSCLC patients with PS ≥ 2.<h4>Methods</h4>We conducted a systematic review and meta-analysis of interventional and observational studies, which reported efficacy and safety data on ICIs in PS ≥ 2 comparing to PS ≤ 1 NSCLC patients. Efficacy endpoints included: Objective Response Rate (ORR), Disease-Control Rate (DCR), Overall Survival (OS), Progression-Free Survival (PFS). Safety endpoint was the incidence of severe (grade≥3) Adverse Events (AE). Random-effects model was applied for meta-analysis. Heterogeneity was assessed using I<sup>2</sup>. The review is registered on PROSPERO (CRD42020162668).<h4>Findings</h4>Sixty-seven studies (n = 26,442 patients) were included. In PS ≥ 2 vs. PS ≤ 1 patients, the pooled odds ratios were: for ORR 0.46 (95 %CI: 0.39-0.54, I<sup>2</sup>:0 %); for DCR 0.39 (95 %CI: 0.33-0.48, I<sup>2</sup>:50 %) and for AEs 1.12 (95 %CI: 0.84-1.48, I<sup>2</sup>:39 %). The pooled hazard ratio for PFS was 2.17 (95 %CI: 1.96-2.39, I<sup>2</sup>:65 %) and for OS was 2.76 (95 %CI: 2.43-3.14, I<sup>2</sup>:76 %). The safety profile was comparable regardless of the PS status.<h4>Interpretation</h4>Patients with impaired PS status are, on average, twice less likely to achieve a response when exposed to ICIs when compared with representative PS ≤ 1 population. For lung cancer patients treated with ICIs, the impaired PS is not only prognostic, but also predictive for response, while the safety profile is not affected. Prospective randomized studies are indispensable to determine whether poor PS patients derive benefit from ICIs.en_US
dc.formatPrint-Electronicen_US
dc.format.extent97 - 106en_US
dc.languageengen_US
dc.language.isoengen_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.subjectHumansen_US
dc.subjectCarcinoma, Non-Small-Cell Lungen_US
dc.subjectLung Neoplasmsen_US
dc.subjectImmunotherapyen_US
dc.subjectProspective Studiesen_US
dc.subjectProgression-Free Survivalen_US
dc.titleEffectiveness and safety of immunotherapy in NSCLC patients with ECOG PS score ≥2 - Systematic review and meta-analysis.en_US
dc.typeJournal Article
dcterms.dateAccepted2021-06-03
rioxxterms.versionVoRen_US
rioxxterms.versionofrecord10.1016/j.lungcan.2021.06.004en_US
dc.relation.isPartOfLung cancer (Amsterdam, Netherlands)en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Thoracic Oncology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Thoracic Oncology/Thoracic Oncology (hon.)
pubs.publication-statusPublisheden_US
pubs.volume158en_US
pubs.embargo.termsNot knownen_US
icr.researchteamThoracic Oncology
dc.contributor.icrauthorPopat, Sanjayen


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