Efficacy of radiotherapy combined with atezolizumab or docetaxel in patients with previously treated NSCLC
Junzhu Xu,
Haitao Wang,
Chi Zhang,
Su-Han Jin,
Xiaofei Chen,
Fangya Tan,
Benjamin Frey,
Markus Hecht,
Jian-Guo Sun,
Udo S. Gaipl,
Hu Ma,
Jian-Guo Zhou
Affiliations
Junzhu Xu
Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, P.R. China
Haitao Wang
Thoracic Surgery Branch, Center for Cancer Research, NCI, NIH, Bethesda, MD 20892, USA
Chi Zhang
Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, P.R. China
Su-Han Jin
Department of Orthodontics, Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China
Xiaofei Chen
Oncology Biometrics, AstraZeneca, Gaithersburg, MD 20850, USA
Fangya Tan
Harrisburg University of Science and Technology, Harrisburg, PA 17101, USA
Benjamin Frey
Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; FAU Profile Center Immunomedicine (FAU I-MED), Friedrich-Alexander- Universität Erlangen-Nurnberg, Erlangen, Germany
Markus Hecht
Department of Radiotherapy and Radiation Oncology, Saarland University Medical Center, Homburg, Germany
Jian-Guo Sun
Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
Udo S. Gaipl
Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; FAU Profile Center Immunomedicine (FAU I-MED), Friedrich-Alexander- Universität Erlangen-Nurnberg, Erlangen, Germany; Corresponding author
Hu Ma
Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, P.R. China; Corresponding author
Jian-Guo Zhou
Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, P.R. China; Translational Radiobiology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; FAU Profile Center Immunomedicine (FAU I-MED), Friedrich-Alexander- Universität Erlangen-Nurnberg, Erlangen, Germany; Corresponding author
Summary: Radiotherapy showed synergy with immunotherapy, yet the comparative effectiveness of combining immunotherapy (iRT) or chemotherapy (CRT) after platinum therapy failure in advanced non-small cell lung cancer (NSCLC) remains unexplored. We analyzed 163 patients (iRT: n = 120 vs. CRT: n = 43) eligible for combination radiotherapy. Before matching, median overall survival (OS) was significantly longer in iRT group (7.79 vs. 4.57 months, hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.41–0.94, p = 0.024). After 1:2 propensity score matching (PSM) and inverse probability of treatment weighting (IPTW), iRT group showed improved OS, consistent with unmatched analysis (PSM, p = 0.033 and IPTW, p = 0.035). Exploratory analysis suggested that PD1+, central memory PD1+, and effector memory PD-L1+ CD4+ T cells were strong predictive biomarkers for iRT-treated patients (POS = 0.025, POS = 0.002, POS = 0.010, respectively). Proliferative CD4+ T celllow was a prognostic (POS = 0.008) and predictive biomarker for iRT (POS < 0.001). Our work revealed iRT was prolonged OS in previously treated advanced NSCLC patients. Additionally, proliferative CD4+ T cell served as prognostic and predictive biomarkers.
