dc.contributor.author | Popat, S | |
dc.contributor.author | Liu, SV | |
dc.contributor.author | Scheuer, N | |
dc.contributor.author | Gupta, A | |
dc.contributor.author | Hsu, GG | |
dc.contributor.author | Ramagopalan, SV | |
dc.contributor.author | Griesinger, F | |
dc.contributor.author | Subbiah, V | |
dc.coverage.spatial | United States | |
dc.date.accessioned | 2022-07-13T14:01:52Z | |
dc.date.available | 2022-07-13T14:01:52Z | |
dc.date.issued | 2022-05-02 | |
dc.identifier | ARTN e2214046 | |
dc.identifier | 2792672 | |
dc.identifier.citation | Jama Network Open, 2022, 5 (5), pp. e2214046 - | en_US |
dc.identifier.issn | 2574-3805 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/5225 | |
dc.identifier.eissn | 2574-3805 | |
dc.identifier.eissn | 2574-3805 | |
dc.identifier.doi | 10.1001/jamanetworkopen.2022.14046 | |
dc.description.abstract | Importance: 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.format | Electronic | |
dc.format.extent | e2214046 - | |
dc.language | eng | |
dc.language.iso | eng | en_US |
dc.publisher | AMER MEDICAL ASSOC | en_US |
dc.relation.ispartof | Jama Network Open | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_US |
dc.subject | Aged | |
dc.subject | Antibodies, Monoclonal, Humanized | |
dc.subject | Carcinoma, Non-Small-Cell Lung | |
dc.subject | Female | |
dc.subject | Humans | |
dc.subject | Lung Neoplasms | |
dc.subject | Male | |
dc.subject | Retrospective Studies | |
dc.subject | Smoking | |
dc.title | Association Between Smoking History and Overall Survival in Patients Receiving Pembrolizumab for First-Line Treatment of Advanced Non-Small Cell Lung Cancer. | en_US |
dc.type | Journal Article | |
dcterms.dateAccepted | 2022-04-04 | |
dc.date.updated | 2022-07-13T13:54:51Z | |
rioxxterms.version | VoR | en_US |
rioxxterms.versionofrecord | 10.1001/jamanetworkopen.2022.14046 | en_US |
rioxxterms.licenseref.startdate | 2022-05-02 | |
rioxxterms.type | Journal Article/Review | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/35612853 | |
pubs.issue | 5 | |
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-status | Published online | |
pubs.volume | 5 | |
dc.contributor.icrauthor | Popat, Sanjay | |
icr.provenance | Deposited by Mr Arek Surman on 2022-07-13. Deposit type is initial. No. of files: 1. Files: popat_2022_oi_220412_1652802128.23385.pdf | |