Yonghong Zhong,1,* Yanxiong Mao,2,* Xiaofang Fu,1 Huaqiong Huang2 

1Department of Respiratory and Critical Care Medicine, Linping Campus, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Huaqiong Huang, Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 jiefang Road, Hangzhou, Zhejiang, 311100, People’s Republic of China, Tel +86 15005818703, Email zr_hhq@zju.edu.cn

Introduction: Squamous non-small cell lung carcinoma (sqNSCLC) is associated with a poorer prognosis and limited treatment options. Sintilizumab combined with chemotherapy is used as first-line treatment for advanced sqNSCLC. However, the efficacy and safety of sintilimab combined with nanoparticle albumin-bound paclitaxel-based chemotherapy for severe squamous NSCLC remain to be unknown in clinical studies.
Methods: Patients with confirmed unresectable stage III/IV sqNSCLC were retrospectively collected between July 1st, 2019, and December 31st. According to performance status (PS) scores, these patients received first-line sintilimab plus nab-PTX-based chemotherapy were divided into severe (PS=2) and non-severe groups (PS=0– 1). The treatment regimen was repeated every 3 weeks for a maximum of six cycles, or until unacceptable toxicity occurred. The primary endpoint of this study was to assess progression free survival (PFS), with secondary endpoints including the objective response rate (ORR), adverse events (AEs) and disease control rate (DCR).
Results: Among 367 patients with unresectable stage III/IV sqNSCLC, 28 male patients, with a median age of 65.5 years, received first-line sintilimab plus nab-PTX-based chemotherapy. These patients were divided into a severe group (11 patients) and a non-severe group (17 patients). The severe group had a significantly higher incidence of chronic obstructive pulmonary disease (COPD) compared to the non-severe group (54.5% vs 11.8%, p = 0.03). The two groups had a similar median number of treatment cycles and safety profiles. Although the severe group showed higher ORR (63.6% vs 47.1%) and DCR (100% vs 76.5%) than the non-severe group, these differences were not statistically significant. Median PFS and Kaplan-Meier curves were also comparable between the groups.
Conclusion: Sintilimab combined with nab-PTX-based chemotherapy was effective and well tolerated in a small sample of severe lung squamous cell carcinoma population. This combination may offer a potential treatment option for these patients.

Keywords: chemotherapy, immunotherapy, severe lung cancer, squamous non-small cell lung carcinoma