Effectiveness of Nivolumab in Second-Line and Later in Patients with Advanced Non-Small Cell Lung Cancer in Real-Life Practice in France and Germany: Analysis of the ESME-AMLC and CRISP Cohorts
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. ESME-AMLC
2.2. CRISP (AIO-TRK-0315)
2.3. Study Population
2.4. Study Period
2.5. Analyses
3. Results
3.1. Patient Characteristics
3.2. Treatment Response, Treatment Duration and Reasons for Discontinuation
3.3. OS and PFS
3.3.1. ESME-AMLC
3.3.2. CRISP
3.4. Factors Associated with Treatment Duration and OS
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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ESME-AMLC | CRISP | ||||||
---|---|---|---|---|---|---|---|
Overall | SQ | NSQ/ Others | Overall | SQ | NSQ/ Others | ||
n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | ||
Cohort Size | N | 2262 | 567 | 1695 | 522 | 133 | 389 |
Year of nivolumab start | 2015 | 186 (8.2) | 63 (11.1) | 123 (7.3) | - | - | - |
2016 | 695 (30.7) | 184 (32.5) | 511 (30.1) | 42 (8.0) | 14 (10.5) | 28 (7.2) | |
2017 | 856 (37.8) | 213 (37.6) | 643 (37.9) | 167 (32.0) | 40 (30.1) | 127 (32.6) | |
2018 | 460 (20.3) | 95 (16.8) | 365 (21.5) | 214 (41.0) | 48 (36.1) | 166 (42.7) | |
2019/2020 * | 65 (2.9) | 12 (2.1) | 53 (3.1) | 99 (19.0) | 31 (23.3) | 68 (17.5) | |
Age (years) at nivolumab start | Median | 64 | 66 | 63 | 66 | 69 | 64 |
Q1–Q3 | 56.9–69.8 | 59.9–72.8 | 55.8–68.8 | 60.0–73.0 | 64.0–76.0 | 59.0–72.0 | |
≥75 | 262 (11.6) | 106 (18.7) | 156 (9.2) | 126 (24.1) | 46 (34.6) | 80 (20.6) | |
Sex | Male | 1560 (69.0) | 465 (82.0) | 1095 (64.6) | 327 (62.6) | 94 (70.7) | 233 (59.9) |
Stage at initial diagnosis | I–II | 176 (7.8) | 64 (11.3) | 112 (6.6) | 18 (3.4) | 5 (3.8) | 13 (3.3) |
IIIA | 181 (8.0) | 60 (10.6) | 121 (7.1) | 9 (1.7) | 4 (3.0) | 5 (1.3) | |
IIIB–IIIC | 326 (14.4) | 132 (23.3) | 194 (11.4) | 44 (8.4) | 18 (13.5) | 26 (6.7) | |
IV | 1550 (68.5) | 305 (53.8) | 1245 (73.5) | 428 (82) | 100 (75.2) | 328 (84.3) | |
ECOG performance status at nivolumab start | 0–1 | 1014 (44.8) | 260 (45.9) | 754 (44.5) | 293 (56.1) | 78 (58.6) | 215 (55.3) |
2 | 247 (10.9) | 61 (10.8) | 186 (11.0) | 92 (17.6) | 23 (17.3) | 69 (17.7) | |
3–4 | 81 (3.6) | 15 (2.6) | 66 (3.9) | 10 (1.9) | 2 (1.5) | 8 (2.1) | |
Missing | 920 (40.7) | 231 (40.7) | 689 (40.6) | 127 (24.3) | 30 (22.6) | 97 (24.9) | |
Smoking status at diagnosis † | Never smoked | 138 (6.1) | 11 (1.9) | 127 (7.5) | 46 (8.8) | 7 (5.3) | 39 (10.0) |
Light former smoker | 93 (4.1) | 20 (3.5) | 73 (4.3) | 44 (8.4) | 11 (8.3) | 33 (8.5) | |
Heavy former smoker | 1139 (50.4) | 317 (55.9) | 822 (48.5) | 200 (38.3) | 56 (42.1) | 144 (37.0) | |
Former smoker of unknown intensity | 27 (1.2) | 5 (0.9) | 22 (1.3) | 17 (3.3) | 8 (6.0) | 9 (2.3) | |
Smoker | 804 (35.5) | 200 (35.3) | 604 (35.6) | 160 (30.7) | 38 (28.6) | 122 (31.4) | |
Missing | 61 (2.7) | 14 (2.5) | 47 (2.8) | 55 (10.5) | 13 (9.8) | 42 (10.8) | |
At least one metastasis at time of nivolumab start | Any location | 2052 (90.7) | 444 (78.3) | 1608 (94.9) | 507 (97.1) | 129 (97.0) | 378 (97.2) |
Bone | 992 (43.9) | 170 (30.0) | 822 (48.5) | 237 (45.4) | 50 (37.6) | 187 (48.1) | |
Brain | 785 (34.7) | 111 (19.6) | 674 (39.8) | 128 (24.5) | 16 (12.0) | 112 (28.8) | |
Symptomatic | 192 (8.5) | 26 (4.6) | 166 (9.8) | NR | NR | NR | |
Asymptomatic | 593 (26.2) | 85 (15.0) | 508 (30.0) | NR | NR | NR | |
Liver | 515 (22.8) | 117 (20.6) | 398 (23.5) | 128 (24.5) | 29 (21.8) | 99 (25.4) | |
PD-L1 testing at nivolumab start ‡ | Testing done | 678 (30.0) | 114 (20.1) | 564 (33.3) | 310 (59.4) | 76 (57.1) | 234 (60.2) |
Positive | 276 (12.2) | 49 (8.6) | 277 (16.3) | 136 (26.1) | 29 (21.8) | 107 (27.5) | |
≥50% | 115 (5.1) | 15 (2.6) | 100 (5.9) | 29 (5.6) | 7 (5.3) | 22 (5.7) | |
1–49% | 154 (6.8) | 25 (4.4) | 129 (7.6) | 92 (17.6) | 20 (15.0) | 72 (18.5) | |
Unknown | 57 (2.5) | 9 (1.6) | 48 (2.8) | 15 (2.9) | 2 (1.5) | 13 (3.3) | |
Negative | 352 (15.6) | 65 (11.5) | 287 (16.9) | 170 (32.6) | 47 (35.3) | 123 (31.6) | |
Not contributive | - | - | - | 4 (0.8) | 0 (0.0) | 4 (1.0) | |
Testing not done | 1584 (70.0) | 453 (79.9) | 1131 (66.7) | 212 (40.6) | 57 (42.9) | 155 (39.8) | |
EGFR | Positive | 79 (3.5) | 2 (0.4) | 77 (4.5) | 24 (4.6) | 2 (1.5) | 22 (5.7) |
ALK | Positive | 19 (0.8) | 3 (0.5) | 16 (0.9) | 10 (1.9) | 1 (0.8) | 9 (2.3) |
ROS | Positive | 14 (0.6) | 1 (0.2) | 13 (0.8) | 8 (1.5) | 1 (0.8) | 7 (1.8) |
Time from initial diagnosis (months) | Median | 9.6 | 8.8 | 9.9 | 7.8 | 7.7 | 7.9 |
Q1–Q3 | 6.2–15.9 | 5.9–15.1 | 6.3–16.2 | 5.2–11.8 | 5.3–11.1 | 5.2–12.2 | |
Line of nivolumab treatment | 2L | 1516 (67.0) | 429 (75.7) | 1087 (64.1) | 433 (83.0) | 122 (91.7) | 311 (79.9) |
3L | 554 (24.5) | 121 (21.3) | 433 (25.5) | 75 (14.4) | 8 (6.0) | 67 (17.2) | |
4L | 141 (6.2) | 16 (2.8) | 125 (7.4) | 11 (2.1) | 3 (2.3) | 8 (2.1) | |
5L+ | 51 (2.3) | 1 (0.2) | 50 (2.9) | 3 (0.6) | 0 (0.0) | 3 (0.8) | |
Previous regimens received (all) | PT-based CT | 2052 (90.7) | 507 (89.4) | 1545 (91.2) | 492 (94.3) | 119 (89.5) | 373 (95.9) |
Non-PT-based CT | 506 (22.4) | 105 (18.5) | 401 (23.7) | 43 (8.2) | 9 (6.8) | 34 (8.7) | |
Targeted therapy | 120 (5.3) | 10 (1.8) | 110 (6.5) | 14 (2.7) | 0 (0.0) | 14 (3.6) | |
Immunotherapy | 5 (0.2) | 0 (0.0) | 5 (0.3) | 13 (2.5) | 6 (4.5) | 7 (1.8) | |
Investigational agents | 171 (7.6) | 34 (6.0) | 137 (8.1) | 5 (1.0) | 1 (0.8) | 4 (1.0) | |
Other combinations | 20 (0.9) | 0 (0.0) | 20 (1.2) | 30 (5.7) | 6 (4.5) | 24 (6.2) | |
Last LoT regimen received prior to nivolumab | PT-based CT | 1590 (70.3) | 430 (75.8) | 1160 (68.4) | 439 (84.1) | 115 (86.5) | 324 (83.3) |
Non-PT-based CT | 461 (20.4) | 98 (17.3) | 363 (21.4) | 38 (7.3) | 8 (6.0) | 30 (7.7) | |
Targeted therapy | 66 (2.9) | 10 (1.8) | 56 (3.3) | 4 (0.8) | 0 (0.0) | 4 (1.0) | |
Immunotherapy | 2 (0.1) | 0 (0.0) | 2 (0.1) | 7 (1.3) | 4 (3.0) | 3 (0.8) | |
Investigational agents | 130 (5.7) | 29 (5.1) | 101 (6.0) | 5 (1.0) | 1 (0.8) | 4 (1.0) | |
Other combinations | 13 (0.6) | 0 (0.0) | 13 (0.8) | 29 (5.6) | 5 (3.8) | 24 (6.2) | |
Time from start of previous LoT until start of nivolumab (months) | Median | 5.5 | 5.5 | 5.5 | 5.4 | 5.4 | 5.6 |
Q1–Q3 | 2.9–8.6 | 3.0–8.0 | 2.9–8.9 | 3.2–8.1 | 3.4–7.8 | 3.0–8.2 | |
<3 | 606 (26.8) | 146 (25.7) | 460 (27.1) | 121 (23.2) | 26 (19.5) | 95 (24.4) | |
≥3–< 6 | 649 (28.7) | 173 (30.5) | 476 (28.1) | 173 (33.1) | 53 (39.8) | 120 (30.8) | |
≥6–<12 | 730 (32.3) | 198 (34.9) | 532 (31.4) | 183 (35.1) | 47 (35.3) | 136 (35.0) | |
≥12 | 277 (12.2) | 50 (8.8) | 227 (13.4) | 44 (8.4) | 7 (5.3) | 37 (9.5) |
Histology | PD-L1 Status at Nivolumab Start | ||||||
---|---|---|---|---|---|---|---|
Overall | SQ | NSQ/Others | Not Tested | Positive | Negative | ||
Cohort Size | N | 522 | 133 | 389 | 212 | 136 | 170 |
Best treatment response | Complete/partial response | 58 (11.1%) | 12 (9.0%) | 46 (11.8%) | 23 (10.8%) | 25 (18.4%) | 10 (5.9%) |
Stable disease | 107 (20.5%) | 27 (20.3%) | 80 (20.6%) | 48 (22.6%) | 21 (15.4%) | 37 (21.8%) | |
Progressive disease | 164 (31.4%) | 41 (30.8%) | 123 (31.6%) | 58 (27.4%) | 52 (38.2%) | 53 (31.2%) | |
Unknown | 193 (37.0%) | 53 (39.8%) | 140 (36.0%) | 83 (39.2%) | 38 (27.9%) | 70 (41.2%) |
ESME-AMLC | CRISP | |||||
---|---|---|---|---|---|---|
Overall | SQ | NSQ/Others | Overall | SQ | NSQ/Others | |
Reason for Discontinuation * | 1861 | 483 | 1378 | 522 | 133 | 389 |
Progression | 1073 (57.7) | 285 (59.0) | 788 (57.2) | 271 (51.9) | 66 (49.6) | 205 (52.7) |
Toxicity | 152 (8.2) | 42 (8.7) | 110 (8.0) | 28 (5.4) | 7 (5.3) | 21 (5.4) |
Gastrointestinal | 19 (1.0) | 4 (0.8) | 15 (1.1) | NR | NR | NR |
Hepatic | 16 (0.9) | 3 (0.6) | 13 (0.9) | NR | NR | NR |
Cutaneous | 8 (0.4) | 5 (1.0) | 3 (0.2) | NR | NR | NR |
Hematological | 10 (0.5) | 4 (0.8) | 6 (0.4) | NR | NR | NR |
Autoimmune | 12 (0.6) | 3 (0.6) | 9 (0.7) | NR | NR | NR |
Other toxicities | 74 (4.0) | 17 (3.5) | 57 (4.1) | NR | NR | NR |
Doctor’s choice/protocol driven | 263 (14.1) | 66 (13.7) | 197 (14.3) | 14 (2.7) | 5 (3.8) | 9 (2.3) |
Patient’s death | 296 (15.9) | 78 (16.1) | 218 (15.8) | NR | NR | NR |
Patient’s choice | 22 (1.2) | 1 (0.2) | 21 (1.5) | NR | NR | NR |
Others | 138 (7.4) | 28 (5.8) | 110 (8.0) | 164 (31.4) | 48 (36.1) | 116 (29.8) |
Missing | 8 (0.4) | 2 (0.4) | 6 (0.4) | 45 (8.6) | 7 (5.3) | 38 (9.8) |
ESME-AMLC | CRISP | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Variable * | Cohort Size | Median | 95% CI | HR (95% CI) | p-Value | Cohort Size | Median | 95% CI | HR (95% CI) | p-Value | |
Age (years) | <70 | 1709 | 2.6 | 2.3–2.8 | Reference | 0.67 | 328 | 2.2 | 1.8–2.5 | Reference | 0.67 |
70–74 | 291 | 2.9 | 2.4–3.4 | 1.06 (0.92–1.21) | 68 | 2.8 | 2.1–3.7 | 0.89 (0.67–1.17) | |||
≥75 | 262 | 2.4 | 2.1–3.1 | 0.98 (0.84–1.14) | 126 | 2.6 | 2.0–3.2 | 1.01 (0.81–1.27) | |||
Sex | Female | 702 | 2.5 | 2.3–2.8 | Reference | 0.55 | 195 | 2.3 | 1.8–2.8 | Reference | 0.29 |
Male | 1560 | 2.7 | 2.4–2.9 | 1.03 (0.93–1.14) | 327 | 2.3 | 1.9–2.8 | 0.90 (0.74–1.09) | |||
ECOG PS | 0 | 228 | 3.7 | 2.8–4.7 | Reference | <0.01 | 68 | 2.8 | 2.1–3.4 | Reference | 0.03 |
1 | 786 | 2.6 | 2.3–2.9 | 1.18 (1.00–1.39) | 225 | 2.3 | 2.0–2.8 | 1.02 (0.76–1.36) | |||
2+ | 328 | 1.4 | 1.3–1.8 | 1.87 (1.55–2.25) | 102 | 1.4 | 1.0–2.3 | 1.29 (0.93–1.79) | |||
Missing | 920 | 3.0 | 2.8–3.3 | 1.12 (0.95–1.31) | 127 | 2.5 | 1.7–3.6 | 0.82 (0.59–1.13) | |||
Smoking status | Non-smokers | 138 | 2.0 | 1.6–2.4 | Reference | 0.16 | NA | ||||
Former smokers | 1259 | 2.6 | 2.3–2.8 | 0.98 (0.80–1.20) | |||||||
Smokers | 804 | 2.8 | 2.5–3.2 | 0.88 (0.71–1.09) | |||||||
Missing | 61 | 2.6 | 1.9–4.0 | 0.84 (0.60–1.19) | |||||||
Metastases | Brain | 785 | 2.5 | 2.3–2.9 | Reference | 0.03 | 128 | 2.1 | 1.4–2.6 | NP | NP |
Other only | 1267 | 2.5 | 2.3–2.8 | 1.07 (0.96–1.18) | 379 | 2.3 | 2.0–2.8 | NP | |||
No metastases | 210 | 3.5 | 3.0–4.7 | 0.87 (0.73–1.03) | 15 | 3.3 | 1.4–7.0 | NP | |||
Time from start of previous LoT until start of nivolumab (months) | <3 | 606 | 1.9 | 1.8–2.3 | Reference | <0.01 | 121 | 1.4 | 1.1–2.1 | Reference | <0.01 |
3–6 | 649 | 2.3 | 1.9–2.4 | 0.99 (0.87–1.11) | 173 | 2.1 | 1.4–2.4 | 0.78 (0.61–1.01) | |||
6–12 | 730 | 3.1 | 2.8–3.5 | 0.80 (0.71–0.91) | 183 | 2.8 | 2.3–3.5 | 0.65 (0.50–0.84) | |||
≥12 | 277 | 4.4 | 3.5–5.5 | 0.63 (0.53–0.75) | 44 | 4.6 | 3.2–7.9 | 0.55 (0.37–0.82) | |||
PD-L1 expression | Positive | 276 | 2.8 | 2.3–3.4 | Reference | 0.03 | 136 | 1.9 | 1.5–2.8 | Reference | 0.06 |
Negative | 352 | 2.3 | 1.8–2.7 | 1.24 (1.03–1.48) | 170 | 2.3 | 1.7–2.8 | 1.31 (1.01–1.68) | |||
Unknown | 1634 | 2.8 | 2.5–2.9 | 1.04 (0.90–1.20) | 216 | 2.4 | 2.2–3.2 | 1.29 (1.02–1.64) | |||
EGFR, ALK or ROS mutations | No | 2154 | 2.7 | 2.5–2.9 | Reference | <0.01 | NA | ||||
Yes | 108 | 2.0 | 1.5–2.3 | 1.50 (1.20–1.87) | |||||||
Year of nivolumab start | 2015 | 186 | 2.2 | 1.9–2.8 | Reference | 0.17 | |||||
2016 | 695 | 2.6 | 2.3–3.0 | 0.99 (0.83–1.17) | 42 | 2.3 | 1.0–5.2 | Reference | 0.08 | ||
2017 | 856 | 2.5 | 2.3–2.8 | 1.00 (0.84–1.18) | 167 | 2.6 | 1.9–3.5 | 1.11 (0.77–1.59) | |||
2018 | 460 | 3.1 | 2.4–3.5 | 0.91 (0.75–1.11) | 214 | 1.9 | 1.4–2.3 | 1.42 (1.00–2.04) | |||
2019/2020 | 65 | 6.2 | 2.3–NE | 0.60 (0.38–0.94) | 99 | 3.1 | 2.4–3.7 | 1.30 (0.86–1.98) | |||
ESME-AMLC | CRISP | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Variable * | Cohort Size | Median | 95% CI | HR (95% CI) | p-Value | Cohort Size | Median | 95% CI | HR (95% CI) | p-Value | |
Age (years) | <70 | 1709 | 12.2 | 10.7–13.9 | Reference | 0.39 | 328 | 7.3 | 5.4–8.5 | Reference | 0.08 |
70–74 | 291 | 12.6 | 9.2–14.8 | 1.08 (0.90–1.29) | 68 | 8.0 | 5.3–18.9 | 0.71 (0.51–1.01) | |||
≥75 | 262 | 9.7 | 7.5–12.6 | 1.12 (0.93–1.34) | 126 | 7.8 | 6.1–11.4 | 1.11 (0.86–1.44) | |||
Sex | Female | 702 | 13.9 | 11.0–16.0 | Reference | 0.04 | 195 | 8.0 | 5.8–9.9 | Reference | 0.58 |
Male | 1560 | 11.2 | 10.0–12.8 | 1.15 (1.01–1.31) | 327 | 7.4 | 5.8–8.9 | 0.94 (0.75–1.17) | |||
ECOG PS | 0 | 228 | 19.8 | 17.0–27.1 | Reference | <0.01 | 68 | 11.8 | 7.9–15.3 | Reference | <0.01 |
1 | 786 | 10.7 | 9.4–12.5 | 1.73 (1.38–2.15) | 225 | 7.8 | 6.2–9.3 | 1.22 (0.86–1.73) | |||
2+ | 328 | 3.7 | 2.9–4.3 | 3.24 (2.55–4.12) | 102 | 3.9 | 2.5–5.5 | 2.00 (1.36–2.94) | |||
Missing | 920 | 15.4 | 13.2–18.0 | 1.42 (1.13–1.77) | 127 | 7.6 | 5.3–13.2 | 1.07 (0.73–1.57) | |||
Smoking status | Non-smoker | 138 | 10.7 | 8.0–17.3 | Reference | 0.07 | 46 | 6.8 | 3.9–17.0 | NP | NA |
Former | 1259 | 10.7 | 9.9–12.4 | 0.96 (0.76–1.22) | 261 | 8.1 | 5.8–11.3 | NP | |||
Current | 804 | 14.7 | 11.6–16.6 | 0.82 (0.64–1.06) | 160 | 7.2 | 5.0–8.1 | NP | |||
Missing | 61 | 14.6 | 7.6–23.8 | 0.75 (0.48–1.15) | 55 | 8.9 | 5.2–12.7 | NP | |||
Metastases | Brain | 785 | 13.0 | 11.0–15.1 | Reference | 0.05 | 128 | 7.1 | 4.1–8.5 | Reference | 0.17 |
Other | 1267 | 10.5 | 9.2–12.5 | 1.07 (0.94–1.22) | 379 | 7.6 | 6.2–9.6 | 0.90 (0.70–1.17) | |||
No metastases | 210 | 14.5 | 12.0–17.3 | 0.84 (0.67–1.04) | 15 | 23.7 | 5.3–NA | 0.44 (0.19–1.05) | |||
Time from start of previous lot until start of nivolumab (months) | <3 | 606 | 7.0 | 6.0–8.3 | Reference | <0.01 | 121 | 4.0 | 2.8–6.1 | Reference | <0.01 |
3–6 | 649 | 9.8 | 8.4–11.6 | 0.86 (0.75–1.00) | 173 | 6.7 | 5.0–7.9 | 0.75 (0.57–1.00) | |||
6–12 | 730 | 15.4 | 14.0–18.5 | 0.61 (0.53–0.71) | 183 | 10.9 | 7.7–13.4 | 0.57 (0.43–0.75) | |||
≥12 | 277 | 23.8 | 18.0–28.0 | 0.44 (0.35–0.55) | 44 | 12.8 | 6.2–19.7 | 0.48 (0.30–0.77) | |||
PD-L1 expression | Positive | 276 | 13.0 | 9.4–18.4 | NP | NA | 136 | 10.8 | 5.8–13.3 | Reference | <0.01 |
Negative | 352 | 10.8 | 8.4–15.8 | NP | 170 | 6.1 | 4.6–7.7 | 1.66 (1.24–2.23) | |||
Unknown | 1634 | 12.0 | 10.6–13.3 | NP | 216 | 7.8 | 6.1–8.9 | 1.39 (1.06–1.82) | |||
Stage at diagnosis | I–II | 176 | 10.9 | 8.7–15.2 | NP | NA | 18 | 27.3 | 6.9–NA | Reference | 0.14 |
III | 507 | 13.4 | 11.2–16.0 | NP | 53 | 12.1 | 6.2–18.0 | 2.02 (0.88–4.62) | |||
IV | 1550 | 11.1 | 10.0–13.0 | NP | 428 | 7.2 | 5.5–8.0 | 2.38 (1.12–5.07) | |||
Missing | 0 | NA | NA | NA | 23 | 7.2 | 4.8–11.4 | 2.19 (0.88–5.48) | |||
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Chouaid, C.; Thomas, M.; Debieuvre, D.; Durand-Zaleski, I.; Zacharias, S.; Bosquet, L.; Groth, A.; Fleitz, A.; Calleja, A.; Patel, S.; et al. Effectiveness of Nivolumab in Second-Line and Later in Patients with Advanced Non-Small Cell Lung Cancer in Real-Life Practice in France and Germany: Analysis of the ESME-AMLC and CRISP Cohorts. Cancers 2022, 14, 6148. https://doi.org/10.3390/cancers14246148
Chouaid C, Thomas M, Debieuvre D, Durand-Zaleski I, Zacharias S, Bosquet L, Groth A, Fleitz A, Calleja A, Patel S, et al. Effectiveness of Nivolumab in Second-Line and Later in Patients with Advanced Non-Small Cell Lung Cancer in Real-Life Practice in France and Germany: Analysis of the ESME-AMLC and CRISP Cohorts. Cancers. 2022; 14(24):6148. https://doi.org/10.3390/cancers14246148
Chicago/Turabian StyleChouaid, Christos, Michael Thomas, Didier Debieuvre, Isabelle Durand-Zaleski, Stefan Zacharias, Lise Bosquet, Annika Groth, Annette Fleitz, Alan Calleja, Sonya Patel, and et al. 2022. "Effectiveness of Nivolumab in Second-Line and Later in Patients with Advanced Non-Small Cell Lung Cancer in Real-Life Practice in France and Germany: Analysis of the ESME-AMLC and CRISP Cohorts" Cancers 14, no. 24: 6148. https://doi.org/10.3390/cancers14246148