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dc.contributor.authorPopat, S
dc.contributor.authorLiu, SV
dc.contributor.authorScheuer, N
dc.contributor.authorGupta, A
dc.contributor.authorHsu, GG
dc.contributor.authorRamagopalan, SV
dc.contributor.authorGriesinger, F
dc.contributor.authorSubbiah, V
dc.coverage.spatialUnited States
dc.date.accessioned2022-07-13T14:01:52Z
dc.date.available2022-07-13T14:01:52Z
dc.date.issued2022-05-02
dc.identifierARTN e2214046
dc.identifier2792672
dc.identifier.citationJama Network Open, 2022, 5 (5), pp. e2214046 -en_US
dc.identifier.issn2574-3805
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/5225
dc.identifier.eissn2574-3805
dc.identifier.eissn2574-3805
dc.identifier.doi10.1001/jamanetworkopen.2022.14046
dc.description.abstractImportance: There is a need to tailor treatments to patients who are most likely to derive the greatest benefit from them to improve patient outcomes and enhance cost-effectiveness of cancer therapies. Objective: To compare overall survival (OS) between patients with a current or former history of smoking with patients who never smoked and initiated pembrolizumab monotherapy as first-line (1L) treatment for advanced non-small lung cancer (NSCLC). Design, Setting, and Participants: This retrospective cohort study compared patients diagnosed with advanced NSCLC aged 18 or higher selected from a nationwide real-world database originating from more than 280 US cancer clinics. The study inclusion period was from January 1, 2011, to October 1, 2019. Exposures: Smoking status at the time of NSCLC diagnosis. Main Outcomes and Measures: OS measured from initiation of 1L pembrolizumab monotherapy. Results: In this retrospective cohort study, a total of 1166 patients (median [IQR] age, 72.9 [15.3] years; 581 [49.8%] men and 585 [50.2%] women) were assessed in the primary analysis, including 91 patients [7.8%] with no history of smoking (ie, never-smokers) and 1075 patients [92.2%] who currently or formerly smoked (ie, ever-smokers). Compared with ever-smokers, never-smokers were older (median age [IQR] of 78.2 [12.0] vs 72.7 [15.5] years), more likely to be female (61 [67.0%] vs 524 [48.7%]) and to have been diagnosed with nonsquamous tumor histology (70 [76.9%] vs 738 [68.7%]). After adjustment for baseline covariates, ever-smokers who initiated 1L pembrolizumab had significantly prolonged OS compared to never-smokers (median OS: 12.8 [10.9-14.6] vs 6.5 [3.3-13.8] months; hazard ratio (HR): 0.69 [95% CI, 0.50-0.95]). This trend was observed across all sensitivity analyses for the 1L pembrolizumab cohort, but not for initiators of 1L platinum chemotherapy, for which ever-smokers showed significantly shorter OS compared with never-smokers (HR, 1.2 [95% CI, 1.07-1.33]). Conclusions and Relevance: In patients with advanced NSCLC who received 1L pembrolizumab monotherapy in routine clinical practices in the US, patients who reported a current or former history of smoking at the time of diagnosis had consistently longer OS than never-smokers. This finding suggests that in never-smoking advanced NSCLC, 1L pembrolizumab monotherapy may not be the optimal therapy selection, and genomic testing for potential genomically matched therapies should be prioritized over pembrolizumab in never-smokers.
dc.formatElectronic
dc.format.extente2214046 -
dc.languageeng
dc.language.isoengen_US
dc.publisherAMER MEDICAL ASSOCen_US
dc.relation.ispartofJama Network Open
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.subjectAged
dc.subjectAntibodies, Monoclonal, Humanized
dc.subjectCarcinoma, Non-Small-Cell Lung
dc.subjectFemale
dc.subjectHumans
dc.subjectLung Neoplasms
dc.subjectMale
dc.subjectRetrospective Studies
dc.subjectSmoking
dc.titleAssociation Between Smoking History and Overall Survival in Patients Receiving Pembrolizumab for First-Line Treatment of Advanced Non-Small Cell Lung Cancer.en_US
dc.typeJournal Article
dcterms.dateAccepted2022-04-04
dc.date.updated2022-07-13T13:54:51Z
rioxxterms.versionVoRen_US
rioxxterms.versionofrecord10.1001/jamanetworkopen.2022.14046en_US
rioxxterms.licenseref.startdate2022-05-02
rioxxterms.typeJournal Article/Reviewen_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/35612853
pubs.issue5
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-statusPublished online
pubs.volume5
dc.contributor.icrauthorPopat, Sanjay
icr.provenanceDeposited by Mr Arek Surman on 2022-07-13. Deposit type is initial. No. of files: 1. Files: popat_2022_oi_220412_1652802128.23385.pdf


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