Impact of renin-angiotensin system inhibitors on the clinical outcomes of nivolumab therapy in metastatic non-small cell lung cancer.
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Mutlu Ozkan Emel, Karadağ Ibrahim, Sahın Elif, Nuransoy Cengiz Ayse, Cengız Muhammet, Can Guven Deniz, Bozkurt Oktay, Inanç Mevlüde, Ozkan Metin, Kefelı Umut, Cabuk Devrim, Erman Mustafa, Kılıckap Saadettin, Kosecı Tolga, Bayır Duygu, Demir Hacer, Yıldız Sedat, Urun Muslih, Sakalar Teoman, Majidova Nargiz, Akosman Cengiz, Ersoy Mustafa, Can Sancı Pervin, Kolemen Erdem, Agdas Gözde, Kocaaslan Erkam, Turkoğlu Ezgi, Yıldırım Sedat, Mermıt Ercek Berrak, Karakayalı Anıl, Arvas Hayati, Kıdı Mehmet Mutlu, Biter Sedat, Cınkır Havva Yesıl, Karahan Latif, Apaydın Rollas Aslihan Ezgi
Аннотация
METHODS: This retrospective cohort multicentre study was conducted on patients with mNSCLC patients treated Nivolumab monotherapy as second line therapy. Factors affecting the survival of patients receiving concurrent RASI therapy with nivolumab were analyzed.
RESULTS: 614 patients were included. A total of 288 patients (46.9%) were using concurrent RASI. Patients using RASIs had a median progression free survival (PFS) of 10 months compared to 7 months in non-users. In the multivariate analysis, RASI use (HR: 0.747, 95% CI: 0.594-0.941; p: 0.013) was associated with improved PFS. RASI use was also significantly associated with overall survival (OS), median OS of 20 months in users and 12 months in non-users. In the multivariate analysis, RASI use (HR: 0.600, 95% CI: 0.458-0.787; p < 0.001) was associated with improved OS.
CONCLUSIONS: In this multicenter real-world study of patients with mNSCLC receiving second-line nivolumab, concomitant use of RASIs was associated with PFS and OS. The integration of RAS blockade into immunotherapy regimens could represent a promising strategy to enhance treatment efficacy.