Real-World Safety and Efficacy of Nivolumab in Advanced Squamous and Nonsquamous Non-Small-Cell Lung Cancer: A Retrospective Cohort Study in Croatia, Hungary, and Malta

Abstract

Background. There is a lack of real-world data on the safety and efficacy of nivolumab in patients with previously treated advanced non-small-cell lung cancer (NSCLC) especially in South East Europe, a region with particularly high incidence and an unfavorable mortality-to-incidence ratio for lung cancer. Objectives. To evaluate the real-world safety and efficacy of nivolumab in patients with previously treated advanced squamous and nonsquamous NSCLC in South East Europe. Methods. This is a multicenter, retrospective cohort study on patients with stage IIIB or IV disease with at least one previous systemic treatment who received nivolumab through an expanded-access program between 2015 and 2017 in Croatia, Malta, and Hungary. The primary endpoint was the proportion of patients whose therapy was discontinued because of toxicity. Secondary endpoints were the incidence of adverse events (AEs), objective response rate (ORR), disease control rate (DCR), time to response (TTR), duration of response (DOR), progression-free survival (PFS), and overall survival (OS). Results. We analyzed data on 239 patients with a median (IQR) age of 62 (57–68), and 33% of them were women. Treatment was discontinued because of toxicity in 11.6% (95% CI 7.8% to 16.5%) of patients. The PFS was 6.4 (95% CI 5.2 to 8.6) months, and the median OS was 14.1 (10.6 to 18.0) months. Conclusions. The safety and efficacy of nivolumab in previously treated patients with advanced NSCLC in the real-world South East Europe clinical settings were consistent with the results of randomized clinical trials and comparable to the results from other countries.

Nivolumab Safety in Renal Cell Carcinoma: A Case Report

“…16 A larger European study recruiting nivolumab-treated patients in Hungary, Malta, and Croatia found that 10 out of 239 (4.2%) patients developed hypothyroidism. 17 A study in Japan found that hypothyroidism developed in 67 out of 200 (33.5%) nivolumab-treated patients. 18 A study carried out in Texas recruited 657 patients treated with an ICI, of whom 43 developed thyroid dysfunction.…”

“…25 In a real-world cohort, pneumonitis occurred in 5 of 239 patients (2.1%) treated with nivolumab. 17 The risk factors for ICI-induced pneumonitis are exposure to tobacco smoke and higher lung tumor burden. It is not known if past thoracic radiotherapy or chronic obstructive pulmonary disease increases the risk of pneumonitis.…”