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Efficacy of PD-1 Inhibitors Combined with Anti-Angiogenic Therapy in Driver Gene Mutation Negative Non-Small-Cell
Jia-Qi Song1, Xia Wang1, Zhi-Min Zeng1
1Department of Oncology, The Second Affiliated Hospital of Nanchang University, 330000 Nanchang, Jiangxi, China.
Objective:
Anti-angiogenic therapy has proven effective in non-small-cell lung cancer (NSCLC) patients. The purpose of this study was to evaluate the efficacy of programmed cell death protein 1 (PD-1) inhibitors combined with anti-angiogenic therapy in patients with driver gene mutation negative NSCLC and brain metastases (BMs).
Methods:
A retrospective analysis was performed on NSCLC BMs in patients without driver gene mutations who received PD-1 inhibitors. Two groups, receiving either PD-1 inhibitor monotherapy or PD-1 inhibitor plus anti-angiogenesis therapy, were identified. The primary endpoints were overall survival (OS) and intracranial progression-free survival (iPFS). The secondary endpoints were safety, intracranial objective response rate (iORR) and intracranial disease control rate (iDCR).
Results:
113 NSCLC patients were included, 51 (45.1%) in the PD-1 inhibitor monotherapy group and 62 (54.9%) in the PD-1 inhibitor plus anti-angiogenesis therapy group. The median follow-up time was 26.2 months. OS was higher in the combination therapy cohort than in the monotherapy cohort (OS: 21.4 vs. 11.8 months; p = 0.004), with no significant difference in iPFS (p = 0.088). Moreover, the PD-1 inhibitor + anti-angiogenic therapeutic regimen exhibited the preferred iDCR (p = 0.005) but not the iORR (p = 0.121). There was no significant difference in the incidence of grade 3-4 adverse events between the two groups. In multivariate Cox regression analysis, PD-1 inhibitor therapy combined with anti-angiogenic treatment (p = 0.003) was an independent prognostic indicator of OS.
Conclusions:
Combining PD-1 inhibitor therapy with anti-angiogenic treatment significantly improves the OS of driver gene mutation negative NSCLC patients with BMs.
Insights
Combining programmed cell death protein 1 (PD-1) inhibitors with anti-angiogenic therapy significantly improves overall survival in non-small-cell lung cancer patients with brain metastases and no driver gene mutations. This combination therapy also shows improved intracranial disease control.
Area of Science:
- Oncology
- Immunotherapy
- Cancer Research
Background:
- Anti-angiogenic therapy is an established treatment for non-small-cell lung cancer (NSCLC).
- The efficacy of combining programmed cell death protein 1 (PD-1) inhibitors with anti-angiogenic therapy in specific NSCLC patient populations remains an area of investigation.
Purpose of the Study:
- To evaluate the efficacy of PD-1 inhibitors combined with anti-angiogenic therapy.
- To assess outcomes in patients with driver gene mutation-negative NSCLC and brain metastases (BMs).
Main Methods:
- Retrospective analysis of 113 NSCLC patients with BMs and no driver gene mutations.
- Comparison between PD-1 inhibitor monotherapy and combination therapy (PD-1 inhibitor + anti-angiogenesis).
- Primary endpoints: Overall Survival (OS) and Intracranial Progression-Free Survival (iPFS). Secondary endpoints: safety, Intracranial Objective Response Rate (iORR), and Intracranial Disease Control Rate (iDCR).
Main Results:
- Combination therapy showed significantly higher OS (21.4 vs. 11.8 months; p=0.004).
- Intracranial Disease Control Rate (iDCR) was significantly improved with combination therapy (p=0.005).
- No significant differences in iPFS (p=0.088) or iORR (p=0.121); similar safety profiles were observed.
Conclusions:
- Combining PD-1 inhibitor therapy with anti-angiogenic treatment significantly improves OS in driver gene mutation-negative NSCLC patients with BMs.
- This combination strategy is an independent prognostic indicator for improved OS in this patient cohort.
