Immunotherapy With Programmed Cell Death 1 Versus Programmed Cell Death Ligand 1 Inhibitors in Patients With Advanced...

Area of Science:

• Oncology
• Immunotherapy
• Clinical Research

Background:

• Advanced non-small cell lung cancer (NSCLC) remains a significant global health challenge.
• Immune checkpoint inhibitors, including programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors, have revolutionized NSCLC treatment.
• Real-world data is crucial for understanding the comparative effectiveness and safety of these therapies in diverse patient populations.

Purpose of the Study:

• To compare the survival outcomes and safety profiles of PD-1 inhibitors versus PD-L1 inhibitors in patients with advanced NSCLC.
• To identify patient characteristics that may influence the efficacy of PD-1 and PD-L1 inhibitors in a real-world setting.

Main Methods:

• Multicenter retrospective study analyzing data from 1266 advanced NSCLC patients in China.
• Kaplan-Meier survival analysis, univariate and multivariate Cox regression, and propensity score matching (PSM) were employed.
• Primary endpoints included overall survival (OS) and progression-free survival (PFS); adverse events were secondary endpoints.

Main Results:

• Patients receiving PD-1 inhibitors demonstrated significantly longer median OS (28.2 months) compared to PD-L1 inhibitors (24.6 months) (HR 0.74, p=0.0099).
• These findings were consistent after PSM and multivariable Cox regression analyses.
• Higher body mass index (BMI ≥ 24 kg/m²) and a history of hypertension were associated with potential interference in PD-1 inhibitor efficacy, though safety profiles were comparable.

Conclusions:

• PD-1 inhibitors offer superior overall survival compared to PD-L1 inhibitors for advanced NSCLC patients in a real-world Chinese cohort.
• Factors such as BMI and hypertension history may warrant consideration for personalized immunotherapy selection.
• The study underscores the importance of real-world evidence in refining personalized treatment strategies for NSCLC.