Current status of the clinical use of PD-1/PD-L1 inhibitors: a questionnaire survey of oncologists in China

Abstract

Background: The purpose of the present study was to obtain information on the use of PD-1/PD-L1 inhibitors by oncologists in China through a national questionnaire survey. Methods: Between the 7th and 25th of July in 2019, a questionnaire designed by the Chinese Society of Clinical Oncology Immuno-Oncology (CSCO IO) Committee on the current status of the use of PD-1/PD-L1 inhibitors was distributed online and offline to cancer-related medical departments in thirty different provinces and autonomous regions of China. The national questionnaire consisted of three sections as follows: general information, current status of the application of PD-1/PD-L1 inhibitors in the clinic, and oncologists' concerns regarding utilization. Results: The valid response rate of the current status survey was 76.3%. The proportion of senior doctors (physician-in-charge or a more superior position for more than 3 years) among the respondents was relatively high (67.0% in 588). Of the respondents, 59.2% had prescribed PD-1/PD-L1 inhibitors during clinical treatment, and the most frequent reason for not prescribing these inhibitors was the choice "do not understand the mechanism and the efficacy of PD-1/PD-L1 inhibitors". In addition, 77.9% of the prescribers used the medications in an off-label situation, and the most important motivation for this use was the fact that "there were indications abroad but not domestically". In addition, 77.9% of the prescribers believed that "immunotherapy-related adverse effects could be controlled or intervened through follow-up management". The prescribers were mostly concerned about "how to identify pseudoprogression and hyperprogression" and "immunity-related adverse effects management". Conclusion: The present study highlights the current status of PD-1/PD-L1 inhibitors in China. Increasing numbers of medical oncologists are interested in PD-1/PD-L1 inhibitors, and they are in need of immunotherapy education.

Primary Squamous Cell Carcinoma of the Liver is Rare but Hostile: Case Series and Comprehensive Review of the Literature

“…Finally, immunotherapy with PD-1 or PD-L1 inhibitors has been approved for treating a variety of advanced human cancers, including lung squamous cell carcinoma, esophageal squamous carcinoma, cutaneous squamous cell carcinoma, and head and neck squamous cell carcinoma. 20 Here we also found that two patients had positive tumor PD-L1 expression, and one patient had positive PD-L1 expression on immune cells, indicating that PD-1/PD-L1 signaling pathway may be activated. Although immunotherapy has not been a clinical therapeutic approach for primary liver SCC, PD-1/PD-L1 blockade by PD-1 inhibitors may be developed as potential agents by activating the host’s anti-cancer immune response.…”

“…In our cases, radiographic findings in major organs were negative and the tumors in the liver were diagnosed as primary. Primary SCC of the liver has been reported to be associated with hepatic cyst, chronic cholecystitis or hepatolithiasis in the majority of reported cases, 8,[11][12][13][14][15][16][17][18][19][20] and focal wall thickening of hepatic cysts or intrahepatic biliary from imaging might indicate a malignant change. However, its pathogenesis remains still uncertain.…”

Design of a Trispecific Checkpoint Inhibitor and Natural Killer Cell Engager Based on a 2 + 1 Common Light Chain Antibody Architecture

“…The PD-1/PD-L1 axis is of major interest as it is an immune checkpoint for T cells (24)(25)(26) as well as for NK cells (27)(28)(29). Originally described as an immune checkpoint for T lymphocytes, the inhibition of the PD-1/PD-L1 axis showed tremendous effects in clinical applications (30)(31)(32). In many malignant cancers, PD-L1 is upregulated to overcome the immune surveillance (33,34).…”

Attitudes and Practices of Immune Checkpoint Inhibitors in Chinese Patients With Cancer: A National Cross-Sectional Survey

“…The survey was developed according to our previous study ( Zhang et al, 2020 ). It was compiled after discussion and modification by the expert committees of the CSCO-IO and CSCO-PE.…”

“…Besides, some preclinical studies have shown that the intestinal flora may significantly affect the efficacy of a therapy targeting PD-1/PD-L1 ( Sivan et al, 2015 ). Recently, we conducted a national questionnaire survey (which covered thirty different provinces and autonomous regions) to investigate the use of PD-1/PD-L1 inhibitors by oncologists in China ( Zhang et al, 2020 ) and found that increasing numbers of oncologists were interested in using PD-1/PD-L1 inhibitors. In this study, we further expanded our search by conducting a more extensive cross-sectional survey.…”