Immune checkpoint inhibitors (ICIs) like atezolizumab have improved outcomes in advanced non-small cell lung cancer (NSCLC) patients, especially in the second-line setting after progression on platinum-based chemotherapy. However, access to ICIs remains limited in many developing nations. This study evaluated the efficacy of atezolizumab as a second-line versus later-line treatment for advanced NSCLC patients in Serbia. Methods: This retrospective study involved 147 advanced NSCLC patients treated with atezolizumab following progression on prior platinum-based chemotherapy at two academic centers in Serbia. Data on demographics and clinical, pathological, and molecular characteristics were collected. Median progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method, and multivariable Cox proportional hazards regression identified outcome predictors. Results: The median PFS was 7.13 months, and median OS was 38.6 months. The overall response rate (ORR) was 15%, with a disease control rate (DCR) of 57.9%. No significant PFS differences were observed between patients treated with atezolizumab in the second line versus later lines. Patients with good performance status (ECOG 0–1) had significantly better PFS compared to those with poorer status (12.03 vs. 1.63 months,p< 0.0001). Conclusions: Atezolizumab is effective in both second-line and later-line settings for advanced NSCLC, particularly in patients with good performance status. This highlights the importance of patient selection based on performance status, as well as the need for wider access to ICIs in resource-limited regions.
以阿替利珠单抗为代表的免疫检查点抑制剂改善了晚期非小细胞肺癌患者的预后，特别是在铂类化疗进展后的二线治疗中。然而，在许多发展中国家，免疫检查点抑制剂的可及性仍然有限。本研究评估了阿替利珠单抗作为二线及后线治疗在塞尔维亚晚期非小细胞肺癌患者中的疗效。方法：这项回顾性研究纳入了塞尔维亚两个学术中心的147例晚期非小细胞肺癌患者，这些患者在既往铂类化疗进展后接受了阿替利珠单抗治疗。收集了人口统计学、临床、病理和分子特征数据。采用Kaplan-Meier法估算中位无进展生存期和总生存期，并通过多变量Cox比例风险回归确定预后预测因素。结果：中位无进展生存期为7.13个月，中位总生存期为38.6个月。总体缓解率为15%，疾病控制率为57.9%。在二线与后线接受阿替利珠单抗治疗的患者之间，无进展生存期无显著差异。体能状态良好（ECOG 0-1分）的患者与状态较差者相比，无进展生存期显著更优（12.03个月 vs. 1.63个月，p < 0.0001）。结论：阿替利珠单抗在晚期非小细胞肺癌的二线及后线治疗中均有效，尤其对于体能状态良好的患者。这凸显了基于体能状态进行患者选择的重要性，以及在资源有限地区扩大免疫检查点抑制剂可及性的必要性。
肿瘤(癌症)患者之家