Durable Disease Control Possible After Stopping Immune Checkpoint Inhibitors in NSCLC
By Elana Gotkine HealthDay Reporter
TUESDAY, April 22, 2025 -- Prolonged disease control can be maintained for patients with advanced non-small cell lung cancer (NSCLC) who discontinue immune checkpoint inhibitors (ICIs) for immune-related adverse events (irAEs), according to a study published online April 18 in Clinical Cancer Research.
Federica Pecci, M.D., from the Dana-Farber Cancer Institute in Boston, and colleagues abstracted clinicopathologic data from patients with advanced NSCLC who received an ICI and discontinued treatment due to irAEs to examine factors associated with postdiscontinuation progression-free survival (PFS) and overall survival (OS).
Overall, 10 percent (271 patients) of the 2,794 patients discontinued ICIs because of irAEs, with a median duration of 5.9 months of ICI treatment before discontinuation due to irAEs. The researchers found that improved postdiscontinuation outcomes were seen in association with longer treatment duration before discontinuation for irAEs, with median postdiscontinuation PFS of 6.2, 13.9, and 25.8 months for patients on an ICI for less than three, three to six, and more than six months, respectively, before discontinuing the ICI, and median postdiscontinuation OS of 21.7, 42.7, and 86.9 months, respectively. Predictors of longer postdiscontinuation PFS were programmed death ligand 1 tumor proportion score ≥50 percent, complete response/partial response to treatment, and treatment duration before discontinuation of three to six or more than six months. Nonsquamous histology, complete response/partial response to treatment, and treatment duration before discontinuation of more than six months were predictors of longer postdiscontinuation OS. Postdiscontinuation outcomes were not affected by use of immunosuppressive agents.
"These results may help guide management strategies and prognostication among patients with advanced NSCLC who experience severe irAE and in whom permanent ICI discontinuation is required," the authors write.
Several authors disclosed ties to the biopharmaceutical industry.
Abstract/Full Text (subscription or payment may be required)
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Posted April 2025
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