Background Bone metastasis (BoM) is common in patients with advanced non-small cell lung cancer (NSCLC) and considered as one of the negative prognostic factors. However, the impact of BoM on clinical outcomes of patients with advanced NSCLC treated with immune checkpoint inhibitors (ICIs) remains unclear. Methods A total of 103 patients treated with ICI monotherapy and 101 patients treated with ICIs combined with chemotherapy or antiangiogenesis therapy were retrospectively analyzed. The differences in progression-free survival (PFS), overall survival (OS) and objective response rate (ORR) between BoM+ and BoM- were investigated. Results Of those 101 patients who received combination therapy, no significant difference between BoM- and BoM+ in terms of both median PFS and median OS (median PFS, 10.1 vs. 12.1 months,P= 0.6; median OS, NR vs. 24.6 months,P= 0.713) was determined. In contrast, of the 103 patients who received ICI monotherapy, BoM+ patients had an inferior PFS (4.2 vs. 6.7 months,P= 0.0484) and OS (12.5 vs. 23.9 months,P= 0.0036) compared with BoM- patients. The univariate and multivariate analysis in the ICI monotherapy group also identified BoM as an independent factor attenuating the efficacy of ICI monotherapy. Of all BoM+ patients who received ICI monotherapy, neither palliative radiotherapy nor bisphosphonate drugs improved OS (palliative radiotherapy: 12.5 vs. 16.7 months,P= 0.487; bisphosphonate drugs: 12.5 vs. 9.7 months,P= 0.568). Conclusions BoM attenuated the efficacy of ICI monotherapy in patients with advanced NSCLC. Of BoM+ patients who received ICI monotherapy, neither palliative radiotherapy nor bisphosphonate drugs improved OS. Other therapeutic strategies are needed for patients with BoM.
基金：
National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81874036 81703020 81702865] Funding Source: Medline
第一作者机构：[1]Tongji Univ, Dept Med Oncol, Sch Med, Shanghai Pulm Hosp, 507 Zheng Min Rd, Shanghai 200433, Peoples R China[2]Hebei Med Univ, Dept Immunooncol, Fourth Hosp, Shijiazhuang, Hebei, Peoples R China
共同第一作者：
通讯机构：[*1]Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, No. 507, Zheng Min Road, Shanghai, 200433, PR China.
推荐引用方式(GB/T 7714)：
Li Xing,Wang Lei,Chen Shanhao,et al.Adverse impact of bone metastases on clinical outcomes of patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors[J].THORACIC CANCER.2020,11(10):2812-2819.doi:10.1111/1759-7714.13597.
APA：
Li, Xing,Wang, Lei,Chen, Shanhao,Zhou, Fei,Zhao, Jing...&Su, Chunxia.(2020).Adverse impact of bone metastases on clinical outcomes of patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors.THORACIC CANCER,11,(10)
MLA：
Li, Xing,et al."Adverse impact of bone metastases on clinical outcomes of patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors".THORACIC CANCER 11..10(2020):2812-2819
