Safety and efficacy of pembrolizumab for advanced nonsmall cell lung cancer: before and during the COVID-19 pandemic

• Published in: Journal of cancer research and clinical oncology 2023-07, Vol.149 (7), p.2951-2961
• Main Authors: Ksienski, Doran, Gupta, Sapna, Truong, Pauline T., Bone, Jeffrey, Chan, Angela, Alex, Deepu, Hart, Jason, Pollock, Philip, Patterson, Tiffany, Clarkson, Melissa, Dissanayake, Dushanthi, Sonke, Eric, Lesperance, Mary
• Format: Article
• Language: English
• Subjects: Cancer Research; COVID-19; Hematology; Internal Medicine; Lung cancer; Medicine; Medicine & Public Health; Non-small cell lung carcinoma; Oncology; Pandemics; Patients; PD-L1 protein; Pembrolizumab; Population studies; Regression analysis; Risk factors; Toxicity
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-022-04181-0

Purpose The COVID-19 pandemic changed diagnostic and treatment pathways in oncology. We compared the safety and efficacy of pembrolizumab amongst advanced nonsmall cell lung cancer (NSCLC) patients with a PD-L1 tumor proportion score (TPS) ≥ 50% before and during the pandemic. Methods Advanced NSCLC patients initiating pembrolizumab between June 2015 and December 2019 (“pre-pandemic cohort”) and between March 2020 and March 2021 (“pandemic cohort”) at BC Cancer were identified retrospectively. Multivariable logistic regression evaluated risk factors for immune-related adverse events (irAE) ≥ grade 3 at the 6 week, 3 month, and 6 month landmarks. Cox regression models of overall survival (OS) were constructed. Results The study population comprised 417 patients in the pre-pandemic cohort and 111 patients in the pandemic cohort. Between March and May 2020, 48% fewer advanced NSCLC cases with PD-L1 TPS ≥ 50% were diagnosed compared to similar intervals in 2018–2019. Telemedicine assessment [new patient consultations ( p