Abstract 46P
Background
Immune checkpoint inhibitors (ICIs) have significantly altered the first-line treatment paradigm for non-small cell lung cancer (NSCLC) without driver gene alterations. The efficacy and safety of different programmed cell death protein-1 (PD-1) inhibitors in the treatment of advanced NSCLC in Chinese real-world clinical practice remain unclear.
Methods
A total of 452 NSCLC patients treated with camrelizumab, pembrolizumab, tislelizumab, or sintilimab as first-line treatment between January 2019 and June 2023 in Jiangsu Cancer Hospital were retrospectively evaluated. Adverse events and patient responses were assessed using Common Terminology Criteria for Adverse Events v5.0 and Response Evaluation Criteria for Solid Tumors v1.1. The progression-free survival (PFS) was estimated using the Kaplan-Meier method or Cox survival regression model and compared using the log-rank test.
Results
There were no significant differences in objective response rate (ORR) and median progression-free survival (mPFS) among the camrelizumab, pembrolizumab, tislelizumab, and sintilimab groups (ORR: 43.0% vs. 40.5% vs. 49.3% vs. 51.0%, P=0.33; mPFS: 8.51 vs. 10.97 vs. 9.43 vs. 9.79 months, P=0.31). Similar incidences of immune-related adverse events (irAEs) at any grade or ≥3 irAEs were observed in different PD-1 inhibitors (P=0.21, P=0.63). The Cox proportional hazard modeling analysis suggested that the type of PD-1 inhibitors was not an independent prognostic factor affecting PFS.
Table 46PTreatment efficacy of different PD-1 inhibitors in patients
| Best overall response | Camrelizumab | Pembrolizumab | Tislelizumab | Sintilimab | P value |
| n/n(%) | 93 | 121 | 140 | 98 | |
| CR | 1(1.1) | 0 | 4(2.9) | 0 | |
| PR | 39(41.9) | 49(40.5) | B5(4B.4) | 50(51.0) | |
| SD | 44(47.3) | B2(51.2) | 5B(40.0) | 39(39.8) | |
| ORR(%) | 43.0 | 40.5 | 49.3 | 51.0 | 0.33 |
| mPFS(months) | 8.51 | 10.97 | 9.43 | 9.79 | 0.31 |
Conclusions
Camrelizumab, pembrolizumab, tislelizumab, and sintilimab possess similar efficacy as first-line treatment options for patients with advanced NSCLC in Chinese clinical practice. Any grade or grade ≥3 irAEs are comparable between the four PD-1 inhibitors.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.