Prognostic role of filgrastim in the effectiveness of PD-1/PD-L1 inhibitors in previously treated patients with non-small cell lung cancer

Abstract

Purpose: To determine whether the use of G-CSF during the first-line therapy of nSCLC influences the effectiveness of anti-PD1/PD-L1 drugs (aPD1-i) used in subsequent therapies.Methods: We designed a single-center, observational, retrospective study with nSCLC patients treated with aPD1-i (nivolumab, pembrolizumab, or atezolizumab) after primary platinum-based chemotherapy in southern Spain. The primary endpoints were overall survival (OS) and progression free survival (PFS). The results were assessed using the Kaplan-Meier method for G-CSF-use.Results: We enrolled 79 patients (91% male) with a mean age of 66.7 years. Nivolumab, atezolizumab, and pembrolizumab were used in 55.7%, 25.3%, and 19.0% of the patients, respectively. G-CSF was administered to 19 patients. The median treatment duration was 4.1 months (95%CI: 2.3-5.8). Overall survival (OS) and progression free survival (PFS) were 7.3 (95%CI: 3.4-11.3) and 4.4 months (95%CI: 2.3-6.5), respectively. The median OS was 15.8 months (95%CI: 1.2-30.3) in G-CSF-treated patients and 5.3 months (95%CI: 2.3-8.3) in the non-treated group (p=0.186). Higher OS was observed in all subgroups.Conclusions: The effectiveness of aPD1-i in previously treated nSCLC patients was higher in the G-CSF-treated group than in the non-treated group, although the difference was statistically insignificant. These results may contribute to improving the effectiveness of anti-PD1/PD-L1 drugs, although confirmatory prospective studies are required.