Survival Impact of Second-Line Immune Checkpoint Inhibitors in Older Patients With Advanced Squamous-Cell NSCLC: Post Hoc Analysis of the CAPITAL Study

Yoshihito Kogure, MD, PhD; Akiko Kada, MPH; Hiroya Hashimoto, PhD; Shinji Atagi, MD; Yuichi Takiguchi, MD; Hideo Saka, MD; Noriyuki Ebi, MD; Akira Inoue, MD; Takayasu Kurata, MD; Yuka Fujita, MD; Yoichi Nishii, MD; Hidetoshi Itani, MD; Takeo Endo, MD; Akiko M. Saito, MD; Takuo Shibayama, MD; Nobuyuki Yamamoto, MD; Akihiko Gemma, MD

JTO Clinical and Research Reports (Jun 2023)

Survival Impact of Second-Line Immune Checkpoint Inhibitors in Older Patients With Advanced Squamous-Cell NSCLC: Post Hoc Analysis of the CAPITAL Study

Yoshihito Kogure, MD, PhD,
Akiko Kada, MPH,
Hiroya Hashimoto, PhD,
Shinji Atagi, MD,
Yuichi Takiguchi, MD,
Hideo Saka, MD,
Noriyuki Ebi, MD,
Akira Inoue, MD,
Takayasu Kurata, MD,
Yuka Fujita, MD,
Yoichi Nishii, MD,
Hidetoshi Itani, MD,
Takeo Endo, MD,
Akiko M. Saito, MD,
Takuo Shibayama, MD,
Nobuyuki Yamamoto, MD,
Akihiko Gemma, MD

Affiliations

Yoshihito Kogure, MD, PhD: Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; Corresponding author. Address for correspondence: Yoshihito Kogure, MD, PhD, Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya 460-0001, Japan.
Akiko Kada, MPH: Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
Hiroya Hashimoto, PhD: Core Laboratory, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Shinji Atagi, MD: Japan Community Health Care Organization Yamatokoriyama Hospital Health Management Center, Yamatokoriyama, Japan
Yuichi Takiguchi, MD: Department of Medical Oncology, Chiba University Hospital, Chiba, Japan
Hideo Saka, MD: Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
Noriyuki Ebi, MD: Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
Akira Inoue, MD: Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan
Takayasu Kurata, MD: Department of Thoracic Oncology, Kansai Medical University Hospital, Osaka, Japan
Yuka Fujita, MD: Department of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center, Asahikawa, Japan
Yoichi Nishii, MD: Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Japan
Hidetoshi Itani, MD: Department of Respiratory Medicine, Japanese Red Cross Ise Hospital, Ise, Japan
Takeo Endo, MD: Division of Respiratory Medicine, National Hospital Organization Mito Medical Center, Mito, Japan
Akiko M. Saito, MD: Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
Takuo Shibayama, MD: Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Okayama, Japan
Nobuyuki Yamamoto, MD: Department of Pulmonary Medicine and Medical Oncology, Wakayama Medical University, Wakayama, Japan
Akihiko Gemma, MD: Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan

Journal volume & issue: Vol. 4, no. 6
p. 100514

Abstract

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Introduction: In the CAPITAL study, a randomized phase 3 study, wherein carboplatin plus nab-paclitaxel treatment was compared with docetaxel treatment for older patients with squamous-cell lung cancer, the former became the new standard of care for such patients. Our study aimed to evaluate whether the efficacy of second-line immune checkpoint inhibitors (ICIs) affected the primary analysis of overall survival (OS). Methods: Herein, we performed a post hoc analysis of the impact of second-line ICIs on OS, safety in each group of participants aged more than 75 years, and intracycle nab-paclitaxel skip status. Results: Patients were randomly allocated to the carboplatin plus nab-paclitaxel (nab-PC) arm (n = 95) or the docetaxel (D) arm (n = 95). Of these patients, 74 of 190 (38.9%) were transferred to ICIs for second-line treatment (nab-PC arm: 36, D arm: 38). A survival benefit was numerically observed only for patients for whom first-line therapy was terminated owing to disease progression (median OS [nab-PC arm]: with and without ICIs, 321 and 142 d, respectively; median OS [D arm]: with and without ICIs, 311 and 256 d, respectively). The OS among patients who received ICI after adverse events was similar in the two arms. In the D arm, a significantly higher frequency of grade greater than or equal to 3 adverse events was observed among patients aged more than or equal to 75 years (86.2%) than among those aged less than 75 years (65.6%, p = 0.041), including a significantly higher frequency of neutropenia (84.6% versus 62.5%, p = 0.032); no such differences were observed in the nab-PC arm. Conclusions: We found that second-line ICI treatment seemed to have a little impact on OS.

Published in JTO Clinical and Research Reports

ISSN: 2666-3643 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.journals.elsevier.com/jto-clinical-and-research-reports/

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