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Abstract：
Background: There are currently few data about the safety and effectiveness of chemotherapy for patients with metastatic non-small-cell lung cancer (NSCLC) who have progressed from prior immunotherapy. Methods: Data from patients with consecutive stage IIIB-IV, ECOG performance status (PS) 0-2, non-small-cell lung cancer (NSCLC) treated with combination or single-agent chemotherapy following progression on an earlier immunotherapy regimen were retrospectively gathered. Recorded were baseline attributes, outcome metrics, and toxicities. The neutrophil/lymphocyte (N/L) ratio\'s predictive usefulness was examined through an exploratory analysis. Results: The analysis comprised one hundred subjects. The adeno/squamous carcinoma ratio was 77%/23%, the M/F ratio was 66%/34%, the ECOG PS was 0/1/≥2 47%/51%/2%, and the median PD-L1 expression was 50% (range 0-100). The median age was 67 (range 39-81) years. Prior immunotherapy included a single-agent treatment in 83% of cases, with pembrolizumab use being prevalent, and a median N/L ratio of four prior to chemotherapy. The overall median time-to-progression on previous immunotherapy was 6 months. After immunotherapy, just 33% of subjects underwent chemotherapy. A median of 4 (range 1-16) cycles of chemotherapy were administered; platinum doublets (primarily carboplatin) were delivered in only 31% of cases, vinorelbine accounted for 25%, taxanes for 25%, and gemcitabine for 8%. The median clinical benefit was 55%, while the overall response rate was 21%. The median overall survival was 5 months (range 1-22) and the median time to progression was 4 months (range 1-17). Subgroups with low and high N/L ratios were compared, but there was no discernible difference in survival. Conclusions: After immunotherapy, a small percentage of patients with advanced NSCLC had chemotherapy. Following immunotherapy advancement, chemotherapy demonstrated a moderate level of therapeutic effectiveness; no adverse concerns were noted. The effectiveness of chemotherapy following immunotherapy was not predicted by the baseline N/L ratio.
摘要：
背景：目前关于化疗对转移性非小细胞肺癌（NSCLC）患者的安全性和有效性的数据很少。方法：来自连续IIIB-IV期患者的数据，回顾性收集了ECOG表现状态（PS）0-2，在较早的免疫治疗方案进展后接受联合或单药化疗治疗的非小细胞肺癌（NSCLC）。记录的是基线属性，结果指标，和毒性。通过探索性分析检查中性粒细胞/淋巴细胞（N/L）比率的预测有用性。结果：分析包括一百名受试者。腺/鳞癌比例为77%/23%，M/F比为66%/34%，ECOGPS为0/1/≥247%/51%/2%，中位PD-L1表达为50%（范围0-100）。中位年龄为67岁（范围39-81岁）。先前的免疫治疗包括83％的病例的单一药物治疗，随着派姆单抗的普遍使用，化疗前的N/L中位数为4。先前免疫疗法的总体中位进展时间为6个月。免疫治疗后，只有33%的受试者接受了化疗.中位化疗周期为4（范围1-16）；只有31%的患者接受了铂双合（主要是卡铂），长春瑞滨占25%，紫杉烷占25%，吉西他滨占8%。中位临床获益为55%，而总有效率为21%。中位总生存期为5个月（范围1-22），中位进展时间为4个月（范围1-17）。比较低和高N/L比的亚组，但是生存率没有明显的差异。结论:免疫治疗后,一小部分晚期NSCLC患者接受了化疗.随着免疫疗法的进步，化疗显示出中等水平的治疗效果;未发现不良问题.免疫疗法后化疗的有效性不能通过基线N/L比预测。
