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Renaud E, Ricordel C, Corre R, Leveiller G, Gadby F, Babey H, Annic J, Lucia F, Bourbonne V, Robinet G, Descourt R, Orione C, Quéré G, Geier M. Pembrolizumab plus pemetrexed-carboplatin combination in first-line treatment of advanced non-squamous non-small cell lung cancer: a multicenter real-life study (CAP29). Transl Lung Cancer Res 2023; 12:266-276. [PMID: 36895931 PMCID: PMC9989798 DOI: 10.21037/tlcr-22-556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/11/2023] [Indexed: 03/01/2023]
Abstract
Background Pembrolizumab combined with chemotherapy is now first-line standard of care in advanced non-small cell lung cancer. This real-life study aimed to assess efficacy and safety of carboplatin-pemetrexed plus pembrolizumab in advanced non-squamous non-small cell lung cancer. Methods CAP29 is a retrospective, observational, multicenter real-life study conducted in 6 French centers. We evaluated efficacy of first-line setting chemotherapy plus pembrolizumab (November 2019 to September 2020) in advanced (stage III-IV) non-squamous non-small cell lung cancer patients without targetable alterations. Primary endpoint was progression-free survival. Secondary endpoints were overall survival, objective response rate and safety. Results With a median follow-up of 4.5 months (0 to 22 months), a total of 121 patients were included. Baseline characteristics were: median age of 59.8 years with 7.4% ≥75 years, 58.7% of males, 91.8% PS 0-1, 87.6% of stage IV with ≥3 metastatic sites in 62% of cases. Patients had brain and liver metastases in 24% and 15.7% of cases, respectively. PD-L1 was <1% (44.6%), 1-49% (28.1%) and ≥50% (21.5%). Median progression-free survival and overall survival achieved 9 and 20.6 months, respectively. Objective response rate was 63.7% with 7 prolonged complete responses. Survival benefit seemed to be correlated with PD-L1 expression. Brain and liver metastases were not statistically associated with decreased overall survival. Most common adverse events were asthenia (76%), anemia (61.2%), nausea (53.7%), decreased appetite (37.2%) and liver cytolysis (34.7%). Renal and hepatic disorders were the main causes of pemetrexed discontinuation. Grade 3-4 adverse events concerned 17.5% of patients. Two treatment-related deaths were reported. Conclusions First-line pembrolizumab plus chemotherapy confirmed real-life efficacy for patients with advanced non-squamous non-small cell lung cancer. With median progression-free survival and overall survival of 9.0 and 20.6 months, respectively and no new safety signal, our real-life data are very close to results provided by clinical trials, confirming the benefit and the manageable toxicity profile of this combination.
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Affiliation(s)
- Emmanuelle Renaud
- Department of Medical Oncology, CHRU Morvan, University Hospital of Brest, Brest, France
| | - Charles Ricordel
- Department of Pulmonary Diseases, CHU Pontchaillou, University Hospital of Rennes, Rennes, France
| | - Romain Corre
- Department of Pulmonary Diseases, CH Cornouaille, Quimper, France
| | | | - Florence Gadby
- Department of Pulmonary Diseases, Hospital of Morlaix, Morlaix, France
| | - Hélène Babey
- Department of Medical Oncology, Hospital of Landerneau, Landerneau, France
| | - Josselin Annic
- Department of Medical Oncology, CHRU Morvan, University Hospital of Brest, Brest, France
| | - François Lucia
- Department of Radiation Oncology, CHRU Morvan, University Hospital of Brest, Brest, France
| | - Vincent Bourbonne
- Department of Radiation Oncology, CHRU Morvan, University Hospital of Brest, Brest, France
| | - Gilles Robinet
- Department of Medical Oncology, CHRU Morvan, University Hospital of Brest, Brest, France
| | - Renaud Descourt
- Department of Medical Oncology, CHRU Morvan, University Hospital of Brest, Brest, France
| | - Charles Orione
- Department of Pulmonary Diseases, CHRU Cavale Blanche University Hospital of Brest, Brest, France
| | - Gilles Quéré
- Department of Medical Oncology, CHRU Morvan, University Hospital of Brest, Brest, France
| | - Margaux Geier
- Department of Medical Oncology, CHRU Morvan, University Hospital of Brest, Brest, France
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Chen R, Fu R, Lin Z, Huang C, Huang W. The efficacy and safety of telitacicept for the treatment of systemic lupus erythematosus: a real life observational study. Lupus 2023; 32:94-100. [PMID: 36416639 DOI: 10.1177/09612033221141253] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the efficacy and safety of telitacicept treatment in a Chinese SLE cohort, with real-life settings. METHODS All patients with SLE who were receiving telitacicept treatment at least 4 weeks were included, and were followed up. Patients received subcutaneous injection of telitacicept weekly based on the standard treatment. SLE responder index-4 (SRI-4) was assessed before the first administration and at least 4 weeks after the first administration. Disease flares during the follow-up period were defined as an increase in disease activity and the number or dose of immunosuppressive drugs. RESULTS After 4-45 weeks' administration of telitacicept, 80% (n = 16) reached SRI-4 response. The prednisolone dosage declined from a mean of 30.25 mg/d (95% CI 21.99-38.51) before treatment to 13.25 mg/d (95% CI 9.92-16.58) after treatment. The proportion of patients without receiving an immunosuppressive drug increased from 15% to 43% at the endpoint. 19 cases showed various reduction of IgM after treatment (p < 0.05) and C3 and C4 showed either stable or an upward trend. The 24 h urinary protein median value of the 14 cases (baseline 24 h urinary protein >0.5 g/d) showed significant reduction, and 7 of them turned negative. Adverse events were mild to moderate and controllable. CONCLUSION Telitacicept is a potential treatment option for patients with SLE, especially in lupus nephritis, with significantly increased SRI-4 response rate and reduced the glucocorticoid and immunosuppressive drugs.
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Affiliation(s)
- Ruilin Chen
- Department of Rheumatology, The Second Affiliated Hospital, 220741Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Rong Fu
- Department of Rheumatology, The Second Affiliated Hospital, 220741Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zeying Lin
- Department of Rheumatology, The Second Affiliated Hospital, 220741Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chenghui Huang
- Department of Rheumatology, The Second Affiliated Hospital, 220741Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wenhui Huang
- Department of Rheumatology, The Second Affiliated Hospital, 220741Guangzhou Medical University, Guangzhou, Guangdong, China
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Hansen S, Hilberg O, Ulrik CS, Bodtger U, M. Rasmussen L, D. Assing K, Wimmer-Aune A, B. Rasmussen K, Bjerring N, Christiansen A, Schmid J, Krogh NS, Porsbjerg C. The Danish severe asthma register: an electronic platform for severe asthma management and research. Eur Clin Respir J 2020; 8:1842117. [PMID: 33209214 PMCID: PMC7646603 DOI: 10.1080/20018525.2020.1842117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 10/22/2020] [Indexed: 12/27/2022] Open
Abstract
The evaluation and management of severe asthma patients require collection of comprehensive information, which is often a challenge in a busy outpatient clinic. The Danish Severe Asthma Register (DSAR) was designed as an electronic patient record form that captures operational clinical data and provides a clinical overview of the severe asthma patient. DSAR is a nationwide register; all patients in Denmark who are treated with biologics for severe asthma are included, and data are as a minimum entered at start of biological treatment, after four and 12 months of treatment, and hereafter annually. Currently, there are data from 621 treatment courses with biologics included in DSAR, with 71% of patients treated with anti-IL-5 drugs and 29% with an anti-IgE drug. Patients enter Patient Reported Outcome Measures electronically on tablets when they arrive in the outpatient clinic and their answers are immediately available to the clinician during the consultation. Nurses and doctors enter clinical data into DSAR during the consultation. DSAR offers immediate access to well-presented longitudinal overview and automatically creates a journal output that can be copy-pasted into the hospital's existing health record form. DSAR is also currently expanding with an app, to be used for monitoring of home-treatment. In addition to serving as an electronic patient record form, DSAR will also provide opportunities to monitor the real-life efficacy of biological treatment for severe asthma in Denmark, and it will be a valuable research platform that will aid in answering important research questions on severe asthma in the future.
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Affiliation(s)
- Susanne Hansen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg & Frederiksberg Hospital, Copenhagen, Denmark
| | - Ole Hilberg
- Department of Respiratory Medicine, Vejle Hospital, Vejle, Denmark
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Uffe Bodtger
- Institute of Regional Health Services Research, University of Southern Denmark, Odense, Denmark
- Department of Respiratory Medicine, Naestved Hospital, Naestved, Denmark
- Department of Respiratory Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Linda M. Rasmussen
- Allergy Clinic, Department of Dermato-Allergology, Gentofte Hospital, Copenhagen, Denmark
| | - Karin D. Assing
- Department of Respiratory Medicine, Aalborg University Hospital, Aalborg, Denmark
| | | | - Kirsten B. Rasmussen
- Department of Respiratory Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Niels Bjerring
- Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
| | - Anders Christiansen
- Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
| | - Johannes Schmid
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
| | - Niels Steen Krogh
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Celeste Porsbjerg
- Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg & Frederiksberg Hospital, Copenhagen, Denmark
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