Assessing the use of anti-PD-1/PD-L1 cancer therapies in the Middle-Eastern Country of Lebanon: a single-center study.

BACKGROUND

Immunotherapy is an effective cancer treatment strategy. Immune checkpoint inhibitors (ICIs), such as anti-PD-1/PD-L1, have demonstrated promising clinical outcomes. In Lebanon, a lower-middle-income country with a history of economic collapse, oncologists began prescribing ICI therapy despite its high cost and the lack of clear evidence regarding the pattern of ICI clinical outcomes in Lebanese patients. The current status of ICIs use in Lebanon remains unclear.

METHODS

This retrospective study involved cancer patients treated with programmed cell death-1 (PD-1/PD-L1) inhibitors at the Central Military Hospital in Beirut, Lebanon. Demographic and clinical data were collected from patients' records from 2016 to 2024.

RESULTS

The study included 118 patients. The hospital covered the patient's treatment. Of those, 59.3% (n = 70) had received ICIs. They were distributed as follows: 58.6% received pembrolizumab; 24.3%, nivolumab; and 17.2%, atezolizumab. Of the patients, approximately 35.7% (n = 25) had undergone a PD-L1 immunohistochemistry (IHC) test prior to receiving the ICI. All PD-L1-positive patients responded to ICI treatment: three showed no tumor progression and 11 showed tumor size regression.

CONCLUSION

The study provided an overview of the use of ICIs at a single center in Lebanon. It revealed that ICI prescriptions were not consistently preceded by a PDL1 positivity test. A significant proportion of patients responded to ICIs, and no association was found between demographics, clinical variables, and clinical outcomes to ICIs.