| Eligibility |
Inclusion Criteria:
- 1. Age of 18-80 years old, both sexes;
- 2. Patients with histologically confirmed advanced non-small cell lung cancer with
stage IIIB /IV disease (according to the International Association for the Study of
Lung Cancer Staging Manual for Thoracic Tumors, 8th edition) or disease recurrence or
progression after multimodal treatment (radiotherapy, surgical resection, or
definitive chemoradiotherapy for locally advanced disease);
- 3. Patients should have no EGFR gene sensitive mutations (including but not limited to
exon 19 deletion, exon 21 L858R mutation, exon 21 L861Q, exon 18 G719X, or exon 20
S768I mutation), ALK gene rearrangement, or ROS1;
Exclusion Criteria:
- 4.Participants had to have measurable lesions on CT or MRI according to RECIST 1.1
(tumor imaging was performed within 28 days before the first dose of study drug) or
clinically significant lesions that could be followed for response according to RECIST
1.1 by the investigator;
- 5. No prior systemic therapy (patients with prior platinum-based adjuvant
chemotherapy, neoadjuvant chemotherapy, or definitive chemoradiotherapy for advanced
disease could enter if disease progression occurred >6 months after the last
treatment);
- 6. Ecog ps =2?;
- 7. Estimated survival time > 12 weeks;
exclusion criteria:
- 1. Subjects requiring systemic treatment with glucocorticoids (>10mg prednisone
equivalent daily) or other immunosuppressive drugs within 14 days before the first
dose of study drug were excluded. Subjects using inhaled or topical corticosteroids,
as well as adrenocortical steroid replacement therapy doses equivalent to >10 mg
prednisone/day, were eligible to participate if they did not have active autoimmune
disease. In addition, the participants had to have discontinued glucocorticoids or
were taking prednisone at a dose of less than 10mg per day (or equivalent) that was
stable or reduced.
- 2. Prior treatment with anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-CTLA-4
antibodies or any other antibody or agent that targets T-cell costimulation or the
immune checkpoint pathway;
- 3. Previous treatment with a trial drug;
- 4. Subjects with active CNS metastases were excluded. Participants could participate
if CNS metastases could be adequately treated and if their neurologic symptoms (other
than residual signs or symptoms related to CNS therapy) returned to baseline at least
2 weeks before enrollment.
- 5. Previous malignant tumor (excluding non-melanoma skin cancer and the following
carcinomas in situ: Cancer in situ of the bladder, stomach, colon, endometrium,
cervix/dysplasia, melanoma, or breast) were excluded unless they had achieved a
complete response at least 2 years before study entry and had not undertaken and did
not require additional therapy (other than antiestrogen/androgen therapy or
bisphosphonate therapy) during the study. Subjects with other active malignant tumors
requiring concurrent treatment were excluded.
- 6. Women with a positive pregnancy test at recruitment or before study dosing;
- 7. Carcinomatous meningitis;
- 8. The subject has a history of interstitial lung disease (e.g., sarcoidosis) that is
symptomatic or may preclude the detection or management of suspected drug-related
pulmonary toxicity;
- 9. Subjects with COPD can be enrolled in the study if the disease is controlled at the
time of enrollment;
- 10. Serious or uncontrolled illness that, in the opinion of the investigator, would
increase the risk associated with participation in the study or administration of the
study drug, affect the ability of the subject to receive the treatment specified in
the protocol, or interfere with the interpretation of the safety results;
- 11. Subjects with active, known, or suspected autoimmune disease. Subjects were
eligible if they had type I diabetes, hypothyroidism requiring only hormone
replacement therapy, skin conditions that did not require systemic treatment (such as
vitiligo, psoriasis, or alopecia), or conditions that were not expected to recist in
the absence of external stimuli;
- 12. All toxicities from previous anticancer treatment (except alopecia and fatigue)
had to have returned to grade 1 (according to NCI CTCAE, version 4) or baseline before
starting the study drug. Subjects were eligible if the toxicity of previous anticancer
therapy was not expected to resolve and resulted in long-term sequelae, such as
neuropathy after treatment with platinum-based agents
- 13. Subjects must have recovered from major surgery or severe trauma for at least 14
days before the first dose of study treatment;
- 14. Subjects who have received previous cellular immunotherapy such as
cytokine-induced killer [CIK] therapy;
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