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Effectiveness and safety of atezolizumab, nivolumab and pembrolizumab in metastatic non-small cell lung cancer.

OBJECTIVE
To determine the effectiveness and safety of atezolizumab, nivolumab and pembrolizumab in patients with non-small  cell lung cancer.


METHOD
This is a retrospective observational study including patients treated in second line and beyond. The effectiveness of treatment  was assessed by means of overall survival and progression free survival  measurements. Toxicity was described according to the Common Criteria  for Adverse Event Terminology v5.0.


RESULTS
The study included 8 patients treated with atezolizumab,19 with nivolumab, and 16 with pembrolizumab. Median progression free  survival with atezolizumab was 9.6 months (95%CI 2-17.2), 12.6 months (95%CI 6.9-18.2) for nivolumab, and 8.5 months (95%CI 0-19)  for pembrolizumab. Median overall survival was 13.4 months (95%CI 6- 20.9) for nivolumab. Both PFS and OS were statistically higher in patients  with grade 0-1 metastasis in the case of nivolumab, and in ECOG 0-1  patients for pembrolizumab. Median overall survival was not reached for  atezolizumab or pembrolizumab. Around 85% of patients suffered adverse  effects of some degree. Two of the patients treated with nivolumab  developed vitiligo. Overall survival of both was higher than 2.5 years.


CONCLUSIONS
For the patients included in the sample, nivolumab was less  effective in those with two or more metastases; the effectiveness of pembrolizumab was lower in ECOG-2 patients. Vitiligo was related to a more durable response to treatment.