First-Line Chemoimmunotherapy versus Sequential Platinum-Based Chemotherapy Followed by Immunotherapy in Patients with Non-Small Cell Lung Cancer with ≤49% Programmed Death-Ligand 1 Expression: A Real-World Multicenter Retrospective Study
, Takayuki Takeda 1,*, Nobutaka Kataoka 1, Akihiro Yoshimura 1, Kentaro Nakanishi 2, Yuta Yamanaka 2, Hiroshige Yoshioka 2, Ryoichi Honda 3, Kiyoaki Uryu 4, Mototaka Fukui 5, Yusuke Chihara 5, Shota Takei 6, Hayato Kawachi 6, Tadaaki Yamada 6, Nobuyo Tamiya 7, Naoko Okura 8, Takahiro Yamada 8, Junji Murai 9, Shinsuke Shiotsu 9, Takayasu Kurata 2 and Koichi Takayama 6add
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Ioannis Vamvakaris
Round 1
Reviewer 1 Report
excellent work.
line 128 is DAKO/AGILENT
THE ONLY THING TO ADD IS THE STATISTICS( IN JAPAN)OF PD-L1 POSITIVITY AND THE NUMBER OF PATIENTS/ECONOMICAL IMPACT IN CASE OF ACCEPTING YOUR CONCLUSIONS AS GUIDELINES
Author Response
I really appreciate your profound understanding of our manuscript. I also thank you for the important comments on our manuscript. I would like to provide the responses to your comments in a point-by-point manner.
line 128 is DAKO/AGILENT
Response:
I really appreciate your suggestion. I added ‘Agilent Technologies’ following “Dako North America’ in accordance with your suggestion.
THE ONLY THING TO ADD IS THE STATISTICS( IN JAPAN)OF PD-L1 POSITIVITY AND THE NUMBER OF PATIENTS/ECONOMICAL IMPACT IN CASE OF ACCEPTING YOUR CONCLUSIONS AS GUIDELINES
Response:
I really appreciate your advice referring to the distribution of PD-L1 expression in the real-world evidence. I added a reference (Respir Res. 2022) to show the proportion of patients with <1% PD-L1 expression. I added a sentence ‘Because patients with <1% PD-L1 expression comprise 66.3% of East-Asian patients with NSCLC (40), this finding would be helpful in the decision making of this population’ in the Discussion section (Lines 379-381).
Reviewer 2 Report
The authors conducted a retrospective study comparing the different sequences of the combination of ICIs and chemotherapy in NSCLC with PD-L1 <= 49%. It is an interesting study, and the conclusion is stable. However, there were several flaws in this manuscript.
Comment 1: The abstract is redundant. The content in lines 34 and 35 is repeated in lines 37 to 42.
Comment 2: The authors should provide detailed information about the process of propensity score matching, including matching by age, sex, stage, histology types, and other relevant factors.
Comment 3: In Figure 4, there were no instructions for C, D, and E. Please add the necessary information.
Author Response
I really appreciate deep understanding of our manuscript. I also thank you for the valuable comments on our manuscript. I would like to provide the responses to your comments in a point-by-point manner.
Comment 1: The abstract is redundant. The content in lines 34 and 35 is repeated in lines 37 to 42.
Response:
I really appreciate your suggestion. The PFS and PFS-2 were described in the Abstract, which made it difficult for the potential readers to understand the contents. Chemoimmunotherapy (CIT) includes platinum-based chemotherapy and ICI, which are administered throughout the PFS-2 period in the sequential administration (SEQ) group. Although I tried to add description to show them in the Abstract, I could not meet the word limit. Then, I did not change the Abstract.
Comment 2: The authors should provide detailed information about the process of propensity score matching, including matching by age, sex, stage, histology types, and other relevant factors.
Response:
I really appreciate your sincere advice. The information on the propensity score matching was described in the Result Section (Lines 168-171) in the original manuscript. I agree with you in that this statistical information should be described in the Patients and Methods. Then I added the description in the Patients and Methods section (2.4. Statistical analysis).
Comment 3: In Figure 4, there were no instructions for C, D, and E. Please add the necessary information.
Response:
I really appreciate your sincere advice. I am sorry for not providing the completed Figure Legends. I made a mistake in the description and corrected them in the revised manuscript (Lines 267-270).
