Brief report: Immune Checkpoint inhibitors use in lung cancer:A Real-World Outcome study in a middle-income country.

Abstract

<title>Abstract</title> <underline> <bold>Introduction</bold> </underline> Lung cancer is the leading cause of cancer death in the world and its treatment represents a major challenge. Treatment with immune checkpoint inhibitors (ICIs) uses cutting-edge technologies and mobilizes a large number of clinical research players. However, the cost may be a barrier to access to these treatments in developing countries. The objective of this study was to evaluate the use of ICIs in lung cancer and assess real-world data of this treatment in Morocco. <underline> <bold>Methods</bold> </underline> This is a retrospective, multicenter cohort study conducted in a Moroccan population diagnosed with lung cancer between January 2019 and January 2022 and treated with ICIs. Patients were recruited from public and private oncology centers of the whole kingdom. Agreement of the ethics committee has been obtained. Survival data, response rates and time till discontinuation of treatment were evaluated using the chi-square test and bivariate analyzes. <underline> <bold>Results</bold> </underline> We included 158 cases representing 5 % of the total number of patients with advanced lung cancer who were eligible for treatment with ICIs. The mean age of patients was 62.48 years and the sex ratio (male/female) was of 4.41. Seventy percent of patient had non-squamous cell carcinoma. <italic>EGFR</italic> status was mutated in 3.9% of the cases. In 34.2% of the cases, the PD-L1 expression status was not known. Forty-seven percent of patients were treated with ICIs monotherapy. Fifty-eight percent of ICIs prescription was in the frontline treatment of lung cancer. The median time to discontinuation of treatment, was 13.53 months. The 12-month overall survival rate was 71.1%.The median overall survival was 17 months. The objective response rate was 40% with 9.3% of patients having grade 3 or 4 toxicities. <underline> <bold>Conclusion</bold> </underline> ICIs have demonstrated very good tolerance with durability of response and survival in a first real-world study dedicated to lung cancer in a developing country.