Real-World Data of Nivolumab and Pembrolizumab in Platinum Refractory Advanced Non-Small Cell Lung Cancer: Potential Practical Predictors of Treatment

The aim of the study was to investigate the real-world nivolumab and pembrolizumab efficacy in patients with platinum-refractory advanced non-small cell lung cancer (NSCLC). We also sought the role of clinicopathologic prognostic and predictive factors. All consecutive patients aged over 18 years who were diagnosed as having platinum-refractory metastatic NSCLC and received at least one dose of nivolumab or pembrolizumab treatment at Dr. Burhan Nalbantoglu State Hospital (Nicosia, Cyprus) and Near East University Hospital (Nicosia, Cyprus) between March 2017 and October 2021 were retrospectively reviewed from patient files, the center???s databases, and chemotherapy ward files. A total of 56 patients treated with nivolumab and pembrolizumab were retrospectively reviewed. The majority of patients (n= 48; 85.7%) received Immune checkpoint inhibitors (ICIs) as second-line therapy and nivolumab was the most commonly (n= 51; 91.1%) used ICI. The median progression-free survival (PFS) and overall survival (OS) were 7.06 (95% CI: 4.43-9.69) months and 11.63 (95% CI: 7.65-15.61) months, respectively. In the entire study population, the objective response rate and disease control rate was 50.0% (complete response: 16.1%, partial response: 33.9%) and 60.7%, respectively. The median duration of responses was 26.40 months (95% CI: 4.17-48.76) (range, 0.67+ to 40.70+ months, with + indicating an ongoing response at the time of analysis). In the multivariate analysis, immun-related adverse events were independently associated with better PFS and OS. This bi-centric real-world data demonstrated that ICIs are standard of care in patients with platinum-refractory advanced NSCLC.