Efficacy and safety analysis of induction therapy for unresectable locally advanced non-small-cell lung cancer: a retrospective study based on IPTW
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Published on: February 12, 2017
Tianlong Chen1, Hongxu Zhang2, Hongtao Yin1
1Department of Radiation Oncology, Harbin Medical University Cancer Hospital, Harbin, China.
Background:
Concurrent chemoradiotherapy (cCRT) followed by consolidation immunotherapy constitutes the current standard of care for unresectable locally advanced non-small cell lung cancer (LA-NSCLC). Despite this approach, a substantial proportion of patients experience disease progression, underscoring the need for novel therapeutic strategies. This study was undertaken to evaluate whether induction chemoimmunotherapy administered prior to definitive CRT can improve clinical outcomes. We evaluated the efficacy and safety of induction chemoimmunotherapy followed by CRT in patients with unresectable LA-NSCLC.
Methods:
A retrospective cohort of patients with unresectable LA-NSCLC treated at the Affiliated Cancer Hospital of Harbin Medical University between January 2020 and October 2022 was analyzed. Patients were classified according to receipt of induction immunochemotherapy into the I-CRT group (n=62) and the CRT group(n=142). Inverse probability of treatment weighting (IPTW) was applied to adjust for baseline confounding. Assess overall survival (OS), progression- free survival (PFS), and safety in the two patient groups.
Results:
After IPTW adjustment, the weighted cohort comprised 286 patients (I-CRT, 104; CRT, 182). In IPTW weighted analyses, median OS was significantly longer in the I-CRT group than in the CRT group (38.8 months vs 23.9 months; hazard ratio [HR], 0.46; 95% confidence interval [CI], 0.28 to 0.77; p = 0.003). Median PFS was also improved with induction chemoimmunotherapy (18.1 months vs 11.7 months; HR, 0.61; 95% CI, 0.39 to 0.95; p=0.028). The overall incidence of treatment-related adverse events (TRAE) was comparable between groups, with the exception of hyperthyroidism, which occurred more frequently in the I-CRT cohort (16. 1% vs 5.6%; p=0.025). Hematologic toxicity was the most common grade ≥3 TRAE. Collectively, the safety profile was acceptable and manageable.
Conclusion:
Induction chemoimmunotherapy administered prior to CRT confers significant and durable improvements in PFS and OS, with a manageable safety profile.