Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Effectiveness of Atezolizumab in Metastatic Large Cell Neuroendocrine Carcinoma of the Lung and the Predictive Value of miR-375. The LANCE Trial, a Pilot Study

Georgios Evangelou
* ORCID logo ,
Ioannis P. Trontzas
,
Ioannis Gkiozos
ORCID logo ,
Ioannis Vamvakaris
,
Maria Grammoustianou
,
Christina Paraskeva
,
Georgia Gomatou
ORCID logo ,
Ioannis Tsamis
,
Ioannis A. Vathiotis
,
Maximilian Anagnostakis
,
Vasiliki Koliaraki
ORCID logo ,
Konstantinos Syrigos
Version 1 : Received: 8 March 2024 / Approved: 11 March 2024 / Online: 11 March 2024 (17:49:38 CET)

How to cite: Evangelou, G.; Trontzas, I.P.; Gkiozos, I.; Vamvakaris, I.; Grammoustianou, M.; Paraskeva, C.; Gomatou, G.; Tsamis, I.; Vathiotis, I.A.; Anagnostakis, M.; Koliaraki, V.; Syrigos, K. Effectiveness of Atezolizumab in Metastatic Large Cell Neuroendocrine Carcinoma of the Lung and the Predictive Value of miR-375. The LANCE Trial, a Pilot Study. Preprints 2024, 2024030593. https://doi.org/10.20944/preprints202403.0593.v1 Evangelou, G.; Trontzas, I.P.; Gkiozos, I.; Vamvakaris, I.; Grammoustianou, M.; Paraskeva, C.; Gomatou, G.; Tsamis, I.; Vathiotis, I.A.; Anagnostakis, M.; Koliaraki, V.; Syrigos, K. Effectiveness of Atezolizumab in Metastatic Large Cell Neuroendocrine Carcinoma of the Lung and the Predictive Value of miR-375. The LANCE Trial, a Pilot Study. Preprints 2024, 2024030593. https://doi.org/10.20944/preprints202403.0593.v1

Abstract

Background: Large-cell neuroendocrine carcinoma presents significant treatment challenges owing to its rarity and limited therapeutic options. The LANCE study was designed to explore the survival benefits of incorporating atezolizumab in chemotherapy for metastatic LCNEC. Methods: In this non-randomized study, patients with metastatic LCNEC were treated with ei-ther standard chemotherapy plus atezolizumab or standard chemotherapy alone. The primary outcomes measured were progression-free survival (PFS) and overall survival (OS), with an ex-ploratory analysis of miR375 in plasma as a potential biomarker. Results: Of the 22 screened patients, 17 met the inclusion criteria and were stratified into the atezolizumab and chemotherapy (n=10) or chemotherapy alone(n=7) groups. After a median follow-up of 23.3 months, the 12-month survival rate for the atezolizumab group was 57.1% (95% CI: 32.6%-100%) and 45.7% at 24 months (95% CI: 22.4%-93.2%). In contrast, the chemotherapy group had a 14.3% survival rate at both 12 and 24 months (95% CI: 2.33%-87.7%). The log-rank test for survival showed a statistically significant difference in the atezolizumab-treated group (chi-squared = 4, df = 1, p = 0.04). A non-significant correlation was found between disease pro-gression and elevated levels of miR375. Conclusions: This pilot study suggests that atezolizumab combined with chemotherapy may be effective in treating metastatic LCNEC. The non-significant correlation between plasma miR375 levels and disease progression suggests its biomarker potential, warranting further validation research.

Keywords

large cell neuroendocrine carcinoma; LCNEC; immunotherapy; atezolizumab; miR375

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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