ArticleCancers2021
Early Progression in Non-Small Cell Lung Cancer (NSCLC) with High PD-L1 Treated with Pembrolizumab in First-Line Setting: A Prognostic Scoring System Based on Clinical Features.
Article in Cancers, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 24 citations in OpenAlex.
- Early Detriment Analysis of First-Line Nivolumab plus Ipilimumab-Based Therapy in Patients with Metastatic Non-Small Cell Lung Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Trial
- Real-world effectiveness of pembrolizumab for first-line treatment of metastatic non-small-cell lung cancer: a decade of evidence and experience.Future oncology (London, England) · 2026Review
- Real-World Evidence That Non-Smokers With High PD-L1 Non-Squamous NSCLC Have Poorer Outcomes With Immune Checkpoint Inhibitors.Thoracic cancer · 2025Article
- PD-L1 Expression and Comprehensive Genomic Profiling in Advanced NSCLC: A Single-Centre Experience.International journal of molecular sciences · 2025Article
- Prognostic score models for acquired resistance to frontline anti-programmed cell death protein 1/programmed death-ligand 1 therapy in metastatic non-small-cell lung cancer.ESMO real world data and digital oncology · 2025Article
- Clinical and dynamic circulating cytokines profile features of long-term progression-free survival benefit to immune checkpoint inhibitors in advanced non-small cell lung cancer.Cancer immunology, immunotherapy : CII · 2025Article
- Pembrolizumab monotherapy survival benefits in metastatic non-small-cell lung cancer: a systematic review of real-world data.Discover oncology · 2024Review
- First-line Treatment Patterns and Outcomes in Advanced Non-Small Cell Lung Cancer in Sweden: A Population-based Real-world Study with Focus on Immunotherapy.Acta oncologica (Stockholm, Sweden) · 2024Article
- Machine learning based on blood test biomarkers predicts fast progression in advanced NSCLC patients treated with immunotherapy.BMJ oncology · 2024Article
- Early mortality factors in immune checkpoint inhibitor monotherapy for advanced or metastatic non-small cell lung cancer.Journal of cancer research and clinical oncology · 2023Article
- Advances in Lung Cancer Therapy.Cancers · 2023Article
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- Impact of Baseline Versus Intercurrent Steroids Administration on Upfront Chemo-Immunotherapy for Advanced Non-Small Cell Lung Cancer (NSCLC).International journal of molecular sciences · 2022Article
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- Review
- Comparison of real-world data (RWD) analysis on efficacy and post-progression outcomes with pembrolizumab plus chemo vs chemo alone in metastatic non-squamous non-small cell lung cancer with PD-L1 < 50.Frontiers in oncology · 2022Article
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundPembrolizumab is approved in monotherapy for the first-line (1L) of advanced or metastatic NSCLC patients with high PD-L1 (≥50%). Despite a proportion of patients achieve long-term survival, about one-third of patients experience detrimental survival outcomes, including early death, hyperprogression, and fast progression. The impact of clinical factors on early progression (EP) development has not been widely explored.
methodsWe designed a retrospective, multicenter study involving five Italian centers, in patients with metastatic NSCLC with PD-L1 ≥ 50%, treated with Pembrolizumab in a 1L setting. EP was defined as a progressive disease within three months from pembrolizumab initiation. Baseline clinical factors of patients with and without EP were collected and analyzed. Logistic regression was performed to identify clinical factors associated with EP and an EP prognostic score was developed based on the logistic model.
resultsOverall, 321 out of 336 NSCLC patients treated with 1L pembrolizumab provided all the data for the analysis. EP occurred in 137 (42.7%) patients; the median PFS was 3.8 months (95% CI: 2.9-4.7), and median OS was not reached in the entire study population. Sex, Eastern Cooperative Oncology Group (ECOG) performance status (PS), steroids, metastatic sites ≥2, and the presence of liver/pleural metastasis were confirmed as independent factors for EP by multivariate analysis. By combining these factors, we developed an EP prognostic score ranging from 0-13, with three-risk group stratification: 0-2 (good prognosis), 3-6 (intermediate prognosis), and 7-13 (poor prognosis). The area under the curve (AUC) of the model was 0.76 (95% CI: 0.70-0.81).
conclusionsWe identified six clinical factors independently associated with EP. We developed a prognostic score model for EP-risk to potentially improve clinical practice and patient selection for 1L pembrolizumab in NSCLC with high PD-L1, in the real-world clinical setting.
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