NSCLC and Malignant Pleural Effusion: Immune Checkpoint Inhibitor Plus Chemotherapy

By: Joshua D. Madera, MD
Posted: Friday, May 24, 2024

For patients with untreated non–small cell lung cancer (NSCLC) who have evidence of metastatic pleural effusions, a novel treatment strategy has demonstrated improved clinical outcomes, according to a study published in BMC Cancer. The combination of immune checkpoint inhibitors and chemotherapy led to a significantly increased progression-free survival in this patient population. However, this therapeutic approach had a limited impact on overall survival, explained Yalun Li, MD, of West China Hospital, Sichuan, and colleagues.

“Randomized clinical trials using immune checkpoint inhibitors plus chemotherapy for patients with NSCLC and metastatic pleural effusions are needed to further elucidate the clinical effect of our findings,” suggested the study authors.

From 2014 to 2023, a total of 155 patients with untreated NSCLC were recruited for this retrospective study. All patients had metastatic pleural effusions. Patients either received treatment with an immune checkpoint inhibitor plus chemotherapy (n = 57) or chemotherapy alone (n = 98). Patients were monitored regularly with CT scans to assess their response to treatment.

The study findings revealed a significantly longer progression-free survival in patients who received an immune checkpoint inhibitor plus chemotherapy (7.4 months) compared with chemotherapy alone (5.7 months, hazard ratio [HR] = 0.594). However, no significant differences in median overall survival were identified between patients treated with an immune checkpoint inhibitor plus chemotherapy (34.2 months) and those treated with chemotherapy alone (28.3 months, HR = 0.746). Furthermore, the most common grade 3 treatment-related adverse events experienced by all patients were neutropenia (5.3% with immune checkpoint inhibitor plus chemotherapy vs 5.1% with chemotherapy alone) and decreased hemoglobin (5.3% vs 10.2%, respectively).

Disclosure: The study authors reported no conflicts of interest.

BMC Cancer

---