The Association between Baseline Hepatic or Renal Function and Clinical Outcomes for Patients with Non-Small Cell Lung Cancer Treated with a PD-1/L1 Blocking Antibody using Real-World and Trials Data.
Qi LiuRaina MathurYuan XuAracelis Z TorresRebecca A MiksadChao LiuHaixia SmithsonYaning WangHao ZhuBrian BoothShiew Mei HuangJizu ZhiRajeshwari SridharaGideon Michael BlumenthalErin LarkinsMPallavi S Mishra-KalyaniDonna R RiveraPaul G KluetzElad SharonPublished in: Clinical pharmacology and therapeutics (2023)
Clinical trials have demonstrated the benefit of PD-1/L1 blocking antibodies for the treatment of patients with advanced non-small cell lung cancer (NSCLC) in defined patient populations that often exclude patients with moderate or severe hepatic or renal impairment. We assessed the association between overall survival (OS) and baseline organ function in patients with advanced NSCLC treated with PD-1/L1 blocking antibodies in real-world data (RWD; patient-level data from electronic-health records) and pooled clinical trials data submitted to the FDA. The Kaplan-Meier estimator was used to estimate OS in different subgroups based on organ function. Unadjusted and adjusted Cox proportional hazards models were used to estimate the association between OS and organ function. In this hypothesis-generating study, baseline renal impairment did not appear to be associated with OS, while patients with baseline liver impairment had shorter OS. RWD provided information on a broader range of renal and hepatic function than was evaluated in clinical trials and holds promise to complement trial data in better understanding populations not represented in clinical trials.
Keyphrases
- electronic health record
- clinical trial
- advanced non small cell lung cancer
- big data
- small cell lung cancer
- phase ii
- phase iii
- clinical decision support
- case report
- study protocol
- randomized controlled trial
- open label
- newly diagnosed
- deep learning
- health information
- tyrosine kinase
- artificial intelligence
- replacement therapy