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Efficacy and safety of nintedanib and docetaxel in patients with previously treated lung non-squamous non-small cell lung cancer: a multicenter retrospective real-world analysis Cover

Efficacy and safety of nintedanib and docetaxel in patients with previously treated lung non-squamous non-small cell lung cancer: a multicenter retrospective real-world analysis

Open Access
|Sep 2023

Figures & Tables

FIGURE 1.

Swimmer plot of treatment duration and best treatment response in EGFR-positive patients. Different colours of the horizontal bars represent different treatment lines, while the symbols at the end of each bar represent the relevant responses.AF = Afatinib; DTX = Docetaxel; DTX_NIN = Docetaxel plus nintedanib; EGFR = epidermal growth factor receptor; ER = Erlotinib; GEM = Gemcitabine; OSM = Osimertinib; PC_CB = Paclitaxel and carboplatin; PD = progressive disease; PR = partial response; PTD_CIS = Pemetrexed and cisplatin; PTD = Pemetrexed; PTD_CB = Pemetrexed and carboplatin; SD = stable disease
Swimmer plot of treatment duration and best treatment response in EGFR-positive patients. Different colours of the horizontal bars represent different treatment lines, while the symbols at the end of each bar represent the relevant responses.AF = Afatinib; DTX = Docetaxel; DTX_NIN = Docetaxel plus nintedanib; EGFR = epidermal growth factor receptor; ER = Erlotinib; GEM = Gemcitabine; OSM = Osimertinib; PC_CB = Paclitaxel and carboplatin; PD = progressive disease; PR = partial response; PTD_CIS = Pemetrexed and cisplatin; PTD = Pemetrexed; PTD_CB = Pemetrexed and carboplatin; SD = stable disease

FIGURE 2.

(A) Progression-free survival of all patients(PFS) (n = 96) treated with nintedanib and docetaxel combination therapy. (B) Overall survival (OS) of all patients treated with nintedanib and docetaxel combination therapy. (C) Progression-free survival (PFS) of patients with and without brain metastases. (D) Median progression-free survival of patients with and without adverse events.
(A) Progression-free survival of all patients(PFS) (n = 96) treated with nintedanib and docetaxel combination therapy. (B) Overall survival (OS) of all patients treated with nintedanib and docetaxel combination therapy. (C) Progression-free survival (PFS) of patients with and without brain metastases. (D) Median progression-free survival of patients with and without adverse events.

FIGURE 3.

Outcomes with docetaxel and nintedanib across different treatment lines. Progression-free survival (PFS) of patients receiving docetaxel plus nintedanib as second-line treatment after first-line combination chemotherapy-checkpoint inhibitors (ChT-ICI) therapy (A), third-line treatment after first-line platinum-based ChT and second-line ICI monotherapy (B), third-line treatment after first-line ICI monotherapy and second-line platinum-based ChT (C), and second-line treatment after first-line platinum-based ChT (D).
Outcomes with docetaxel and nintedanib across different treatment lines. Progression-free survival (PFS) of patients receiving docetaxel plus nintedanib as second-line treatment after first-line combination chemotherapy-checkpoint inhibitors (ChT-ICI) therapy (A), third-line treatment after first-line platinum-based ChT and second-line ICI monotherapy (B), third-line treatment after first-line ICI monotherapy and second-line platinum-based ChT (C), and second-line treatment after first-line platinum-based ChT (D).

Demographic and baseline characteristics of 96 patients treated with docetaxel plus nintedanib

VariableN = 96
Age, mean (years)59.5 (39–75)
Sex
  Male55 (57.3%)
  Female41 (42.7%)
ECOG performance status
  035 (36.4%)
  157 (59.4%)
  24 (4.2%)
Smoking status
  Current smokers56 (58.3%)
  Never smokers18 (18.8%)
  Former smokers18 (18.8%)
  Unknown4 (4.2%)
Clinical stage at diagnosis
  Stage ≤ IIIB9 (9.4%)
  Stage IIIC1 (1.0%)
  Stage IV86 (89.6%)
Brain metastases
  Yes18 (18.7%)
  No78 (81.3%)
PD-L1 expression
  0%35 (36.5%)
  1–49%34 (35.4%)
  ≥ 50%16 (16.7%)
  Unknown11 (11.5%)
Biomarker testing
  EGFR mutation positive5 (5.2%)
   ALK re arrangement present0 (0.0%)
   ROS1 rearrangement present0 (0.0%)
   KRAS mutation present7 (7.3%)
   MET rearrangement present1 (1.0%)
  RET rearrangement present3 (3.1%)
  FGFR rearrangement present1 (1.0%)
Docetaxel plus nintedanib line
  Second-line therapy after first line combination ChT-ICI24 (25%)
  Second-line therapy after first-line platinum-based ChT7 (7.3%)
  Third-line therapy after first-line ChT and second-line ICI47 (49.0%)
  Third-line therapy after first-line ICI and second-line ChT13 (13.5%)
  Fourth or later-lines3 (3.1%)
  Other¶2 (2.1%)

Response to treatment with docetaxel plus nintedanib in all patients

Tumor response according to RECIST version 1.1 criteria10All patientsN = 96
CR0 (0.0)
PR18 (18.8)
SD37 (38.5)
PD31 (32.3)
ORR (CR+PR)18 (18.8)
DCR (CR+PR+SD)55 (57.3)
Non-evaluable10 (10.4)
Median PFS, months3.0 (95% CI: 3–5)
Median OS, months8.0 (95% CI: 7–10)

Response to treatment with docetaxel plus nintedanib in different treatment patterns

Tumor response according to RECIST version 1.1 criteria7Second-line after a first-line combination ChT-ICI regimen (n = 24)Second-line after a first-line platinum-based ChT (n = 7)Third-line therapy following first-line ChT and second-line ICI (n = 47)Third-line after first-line ICI and second-line ChT (n = 13)Fourth or later-line treatment (n = 3)
CR, n (%)0 (0.0)0 (0.0)0 (0.0)0 (0.0)0 (0.0)
PR, n (%)7 (29.2)1 (14.3)9 (19.1)1 (7.7)0 (0.0)
SD, n (%)9 (37.5)2 (28.6)18 (38.3)7 (53.8)1(33.3)
PD, n (%)3 (12.5)3 (42.9)18 (38.3)5 (38.5)2(66.7)
ORR, n (%)7 (29.2)1 (14.3)9 (19.1)1 (7.7)0 (0.0)
DCR, n (%)16 (66.7)3 (42.9)27 (57.4)8 (61.5)1(33.3)
Non-evaluable, n (%)5 (20.8)1 (14.3)2 (4.3)0 (0.0)0 (0.0)

Overview of adverse events with docetaxel plus nintedanib treatment

Adverse Event*All grades n (%)Grade 3 n (%)
Total53 (55.2)8 (8.3)
Diarrhea29(30.2)1 (1.0)
Elevated liver enzymes17(17.7)6 (6.3)
Rash6 (6.2)
Neutropenia4 (4.2)
Peripheral neuropathy3 (3.1)
Stomatitis2 (2.1)
Nausea2 (2.1)
Hypertension2 (2.1)1 (1.0)

Differences in progression-free survival (PFS) and overall survival (OS) for each subset of patients according to the treatment line of docetaxel plus nintedanib

All patients (n = 96)Second-line after a first-line combination ChT-ICI regimen (n = 24)Second-line after a first-line platinum-based ChT (n = 7)Third-line therapy after first-line ChT and second-line ICI (n = 47)Third-line after first-line ICI and (n = 13) second-line ChTFourth- or later-lines treatment (n = 3)
Median progression-free survival, months (95% CI)3 (3–5)4 (3–8)2 (1–inf)4 (3–8)4 (3–inf)3 (0–inf)
Median overall survival, months (95% CI)8 (7–10)9 (6–inf)10 (4–inf)10 (8–14)7 (3–inf)8 (2–inf)
DOI: https://doi.org/10.2478/raon-2023-0040 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 397 - 404
Submitted on: May 15, 2023
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Accepted on: Jul 16, 2023
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Published on: Sep 4, 2023
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2023 Lidija Ljubicic, Urska Janzic, Mojca Unk, Ana Sophie Terglav, Katja Mohorcic, Fran Seiwerth, Lela Bitar, Sonja Badovinac, Sanja Plestina, Marta Korsic, Suzana Kukulj, Miroslav Samarzija, Marko Jakopovic, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.