Continuation of anti-PD-1 therapy plus physician-choice treatment beyond first progression is not associated with clinical benefit in patients with advanced non-small cell lung cancer

Frontiers in Immunology

Immunology

Sha Fu¹  Hongyun Zhao²  Yixing Wang³  Xuanye Zhang³  Yan Huang³  Yunpeng Yang³  Yuanyuan Zhao³  Wei Du³  Shaodong Hong³  Wenfeng Fang³  Linfeng Luo³  Li Zhang³  Yongluo Jiang⁴  Yixin Zhou⁵ 

[1]Department of Cellular & Molecular Diagnostics Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China

[2]Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation of Sun Yat-Sen University, Guangzhou, China

[3]State Key Laboratory of Oncology in South China, Guangzhou, China

[4]Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

[5]Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China

[6]State Key Laboratory of Oncology in South China, Guangzhou, China

[7]Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

[8]Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China

[9]State Key Laboratory of Oncology in South China, Guangzhou, China

[10]Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

[11]Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China

[12]State Key Laboratory of Oncology in South China, Guangzhou, China

[13]Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

[14]Department of VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, China

关键词: immune checkpoint inhibitors;    disease progression;    second-line therapy;    non-small-cell lung cancer;    clinical benefit;   

DOI  :  10.3389/fimmu.2023.1151385

 received in 2023-02-19, accepted in 2023-05-15,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveFew data are available on the optimal treatment options after disease progression from first-line treatment of immune checkpoint inhibitors (ICIs) plus chemotherapy. This study aimed to describe the safety and efficacy of continuing ICIs beyond first progress disease (PD) in non-small cell lung cancer (NSCLC).MethodsPatients with NSCLC previously treated with first-line anti-PD-1 antibody plus platinum-doublet chemotherapy and hence had PD as per Response Evaluation Criteria in Solid Tumors v1.1 were enrolled. For the subsequent line, patients received physician’s choice (PsC) with or without an anti-PD-1 antibody. The primary outcome was progression-free survival after second-line treatment (PFS2). Secondary outcomes included overall survival (OS) from the initiation of first-line treatment, post-second-progression survival (P2PS), overall response rate (ORR), disease control rate (DCR), and safety during second-line treatment.ResultsBetween July 2018 and January 2021, 59 patients were included. A total of 33 patients received a physician-decided second-line regimen plus ICIs (PsC plus ICIs group), and 26 patients did not continue ICIs (PsC group). There was no significant difference in PFS2 between the PsC plus ICIs group and the PsC group (median, 6.5 vs. 5.7 months, p = 0.46). median OS (28.8 vs. 29.2 months), P2PS (13.4 vs. 18.7 months), ORR (18.2% vs. 19.2%), and DCR (78.8% vs, 84.6%) were also similar between the two groups. No new safety signals were observed.ConclusionIn this real-world setting, patients treated with continued ICIs beyond their first disease progression did not experience clinical benefit but without compromising safety.

【 授权许可】

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Copyright © 2023 Wang, Fu, Zhang, Du, Luo, Jiang, Zhou, Zhao, Yang, Zhao, Fang, Huang, Zhang and Hong