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[Clinical Analysis of Docetaxel Combined with PD-1/PD-L1 Inhibitor in Second-line Treatment of Advanced Non-small
Qing Chen1, Yan Li1, Wenjie Zhang1,2
1Department of Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China.
Background:
Programmed cell death 1 or programmed cell death ligand 1 inhibitor (PD-1/PD-L1 inhibitor) and docetaxel, as the standard second-line treatments of advanced non-small cell lung cancer (NSCLC) patients, have limited effects. There are few studies on whether docetaxel combined with PD-1/PD-L1 inhibitor can increase the efficacy and make patients better benefit. The aim of this study is to evaluate the efficacy and safety of docetaxel combined with PD-1/PD-L1 inhibitor for the second-line treatment of stage IV NSCLC patients.
Methods:
Stage IV NSCLC patients (n=118) who received treatment at Shandong Cancer Hospital between October 1, 2018, and December 31, 2020, were retrospectively analyzed. They were divided into observation group (n=69) and control group (n=49) according to different treatment plan. Observation group was given docetaxel plus PD-1/PD-L1 inhibitor, while control group was given PD-1/PD-L1 inhibitor. The clinical curative effect and the incidence of adverse reactions of grade 3 and above were compared between the two groups.
Results:
The disease control rate (DCR) was higher in the observation group (89.9%) than that in the control group (73.5%) (P=0.019), and the objective response rate (ORR) showed no significant difference between observation group (24.6%) and control group (16.3%) (P=0.276). Till June 22, 2021, the 1-year PFS rate showed no difference between observation group (16.5%) and control group (7.7%) (P=0.205). During the treatment period, the adverse reactions of the two groups were mostly grade 1 to 2, and could be tolerated. The incidence of bone marrow suppression in observation group was higher than that in the control group (P<0.05), and the remaining adverse reactions were not statistically different from control group. Cox regression analysis showed that performance status (PS) (P=0.020) and age (P=0.049) were independent prognostic factors for the effect of docetaxel combined with PD-1/PD-L1 inhibitor.
Conclusions:
The second-line treatment with docetaxel plus PD-1/PD-L1 inhibitor in patients with stage IV NSCLC can improve the DCR and prolong the PFS, and the adverse reactions are tolerable.
Insights
Adding docetaxel to programmed cell death 1/ligand 1 inhibitors improves disease control in advanced non-small cell lung cancer. This combination therapy is tolerable and offers potential benefits for patients receiving second-line treatment.
Area of Science:
- Oncology
- Immunotherapy
- Pharmacology
Background:
- Advanced non-small cell lung cancer (NSCLC) has limited treatment options.
- Standard second-line treatments, including programmed cell death 1/ligand 1 (PD-1/PD-L1) inhibitors and docetaxel, show limited efficacy.
- The combination of docetaxel with PD-1/PD-L1 inhibitors for second-line treatment requires further investigation.
Purpose of the Study:
- To evaluate the efficacy and safety of combining docetaxel with PD-1/PD-L1 inhibitors.
- To compare this combination therapy against PD-1/PD-L1 inhibitors alone as a second-line treatment for stage IV NSCLC.
- To identify prognostic factors influencing treatment outcomes.
Main Methods:
- Retrospective analysis of 118 stage IV NSCLC patients treated between October 2018 and December 2020.
- Patients were divided into an observation group (docetaxel + PD-1/PD-L1 inhibitor) and a control group (PD-1/PD-L1 inhibitor).
- Clinical curative effect and incidence of grade 3 adverse reactions were compared.
Main Results:
- The observation group showed a higher disease control rate (DCR) (89.9%) compared to the control group (73.5%) (P=0.019).
- Objective response rate (ORR) and 1-year progression-free survival (PFS) rates did not differ significantly between groups.
- Bone marrow suppression was more frequent in the observation group, but overall adverse reactions were tolerable.
Conclusions:
- Docetaxel plus PD-1/PD-L1 inhibitor combination therapy improves DCR in stage IV NSCLC patients.
- This combination is a tolerable second-line treatment option, potentially prolonging PFS.
- Performance status and age are independent prognostic factors for treatment efficacy.
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