Efficacy of immune checkpoint inhibitor rechallenge in initial immunotherapy responders with advanced non-small cell lung cancer: A single-center retrospective study.

IF 3 3区 医学 Q2 ONCOLOGY Investigational New Drugs Pub Date : 2024-12-01 Epub Date: 2024-12-02 DOI:10.1007/s10637-024-01483-7
Manyi Xu, Yanhua Wang, Ke Wang, Yue Hao, Chunwei Xu, Lei Shi, Zhengbo Song
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Abstract

Background: The efficacy of immune rechallenge in patients with advanced non-small cell lung cancer (NSCLC) who responded well to initial immune checkpoint inhibitor (ICI) treatment is becoming a research hotspot. This study was aimed at describing the survival and clinical characteristics after immune rechallenge in initial immunotherapy responders.

Patients and methods: We retrospectively identified 104 patients with advanced NSCLC who responded well in the first ICI and were rechallenged with immunotherapy to treat progression between January 2018 and June 2023 at Zhejiang Cancer Hospital. Progression-free survival (PFS) 2 and overall survival (OS) were defined as the time from the first day of the second ICI to the date of progression, death, or last follow-up.

Results: Of 104 enrolled patients, 33 received immune monotherapy, and 71 were rechallenged with combination therapy (34 combined with anti-angiogenesis therapy). Patients with an initial immunotherapy duration exceeding 12 months, compared with a duration within 12 months, achieved a significantly prolonged mPFS2 and mOS (PFS2: 9.2 vs. 3.4 months, P < 0.001; OS: 25.5 vs. 10.7 months, P = 0.006). Patients rechallenged with combination therapy had significantly longer PFS2 than those receiving monotherapy (5.8 vs. 2.5 months, P = 0.040), and showed a favorable OS trend (15.9 vs. 10.1 months, P = 0.301). A significant difference in PFS2, particularly for patients receiving combined treatment with anti-angiogenesis therapy (8.7 vs. 4.6 months, P = 0.011), and a tendency toward longer OS (25.3 vs. 13.7 months, P = 0.090), were observed. Multivariate analysis identified long-term treatment duration (P = 0.005) and combined treatment with anti-angiogenesis therapy (P = 0.030) as independent positive factors associated with PFS after rechallenge.

Conclusion: Immune rechallenge is recommend for responders with a prolonged initial immunotherapy duration. Combination therapy, particularly that including anti-angiogenic therapy, is an alternative effective approach to immune rechallenge.

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免疫检查点抑制剂再挑战对晚期非小细胞肺癌初始免疫治疗应答者的疗效:一项单中心回顾性研究
背景:免疫再挑战对初始免疫检查点抑制剂(ICI)治疗反应良好的晚期非小细胞肺癌(NSCLC)患者的疗效正成为研究热点。本研究旨在描述初始免疫治疗应答者在免疫再挑战后的生存和临床特征。患者和方法:我们回顾性地确定了2018年1月至2023年6月在浙江肿瘤医院进行的104例晚期非小细胞肺癌患者,他们在第一次ICI中反应良好,并再次接受免疫治疗以治疗进展。无进展生存期(PFS) 2和总生存期(OS)定义为从第二次ICI的第一天到进展、死亡或最后一次随访的时间。结果:104例入组患者中,33例接受免疫单药治疗,71例再次接受联合治疗(34例联合抗血管生成治疗)。初始免疫治疗时间超过12个月的患者与初始免疫治疗时间在12个月以内的患者相比,mPFS2和mOS显著延长(PFS2: 9.2个月vs 3.4个月)。联合治疗,特别是包括抗血管生成治疗,是免疫再挑战的另一种有效方法。
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来源期刊
CiteScore
7.60
自引率
0.00%
发文量
121
审稿时长
1 months
期刊介绍: The development of new anticancer agents is one of the most rapidly changing aspects of cancer research. Investigational New Drugs provides a forum for the rapid dissemination of information on new anticancer agents. The papers published are of interest to the medical chemist, toxicologist, pharmacist, pharmacologist, biostatistician and clinical oncologist. Investigational New Drugs provides the fastest possible publication of new discoveries and results for the whole community of scientists developing anticancer agents.
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