CHEST Guidelines-Real-World-Outcomes-of-Patients-With-Advanced-Non-

Real-World-Outcomes-of-Patients-With-Advanced-Non-

Pdf Summary

The study evaluates the real-world outcomes of patients with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICI) based on PD-L1 expression, comparing results obtained from endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) samples to those from histological specimens. Conducted from June 2016 to June 2019, the study involved 145 patients treated either with pembrolizumab or nivolumab. It aimed to determine if treatment based on PD-L1 results from the less invasive EBUS-TBNA offers comparable outcomes to those from more traditional histological samples.<br /><br />The study found no significant difference in overall survival (OS) and progression-free survival (PFS) for patients treated based on PD-L1 results from EBUS-TBNA compared to those from histological samples. This was consistent for both first-line and subsequent lines of ICI therapy. Specifically, the median OS for patients who received first-line pembrolizumab based on PD-L1 results in EBUS-TBNA vs histology samples were not significantly different (25.8 months vs not reached).<br /><br />The results suggest that EBUS-TBNA samples can effectively guide ICI therapy, presenting a comparable alternative to histological specimens for PD-L1 testing in the context of treating advanced NSCLC. These findings align with limited prior data, supporting the feasibility and adequacy of EBUS-TBNA for determining PD-L1 status, which is crucial for decision-making regarding ICI therapy. The study acknowledges limitations, including its retrospective nature and the small patient cohort, which constrained a formal equivalence analysis between the two sample types.<br /><br />Overall, the study supports the use of EBUS-TBNA as a reliable approach for PD-L1 testing in real-world clinical practice, potentially streamlining the treatment of advanced NSCLC by leveraging a less invasive method without compromising therapeutic outcomes.

Keywords

NSCLC

immune checkpoint inhibitors

PD-L1 expression

EBUS-TBNA

histological specimens

pembrolizumab

nivolumab

overall survival

progression-free survival

retrospective study