The efficacy of ICIs rechallenge in advanced small cell lung cancer after progression from ICIs plus chemotherapy: A real-world study

IF 4.8 2区医学 Q2 IMMUNOLOGY International immunopharmacology Pub Date : 2025-03-05 DOI:10.1016/j.intimp.2025.114372

Fen Liu , Guisen Yin , Ye Tao , Yong Pan

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Abstract

Background

Rechallenging immune checkpoint inhibitors(ICIs) after resistance to initial ICIs plus chemotherapy(chemo-ICIs) remains uncertain in advanced small cell lung cancer(SCLC).

Method

The study retrospectively enrolled advanced SCLC patients who received ICIs after developing resistance to chemo-ICIs during hospitalization at Hunan Cancer Hospital from January 2020 to November 2023. The clinical outcomes and prognosis factors for ICIs rechallenge were further analyzed.

Results

A total of 175 patients were included, of which 82(46.86 %) patients had primary resistance(PR) and 93(53.14 %) patients developed acquired resistance(AR). The progression-free survival(PFS), objective response rate (ORR), and disease control rate (DCR) of the total group were 3.3 months,16.57 %, and 53.71 %, respectively. The AR group exhibited significantly longer PFS compared to the PR group (4.5 months vs. 3.2 months, p = 0.012). In the PR group, a significantly longer PFS was found for ICIs rechallenge with interval treatment than without interval treatment(4.2 months vs. 3.1 months, p = 0.031). Within the AR group, the “new immunotherapy plus new chemotherapy” regimen showed a significantly longer PFS compared to the regimen of “maintain immunotherapy plus new chemotherapy” (8.3 months vs. 3.2 months, p = 0.014). The multivariate COX regression analyses demonstrated that both resistance pattern(p = 0.007) and treatment regimen(p = 0.039) independently served as risk factors for PFS in ICIs rechallenge.

Conclusion

Our study suggests that rechallenge of ICIs could be considered as a potential therapeutic strategy for advanced SCLC after progression from chemo-ICIs, particularly in patients with AR.

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来源期刊

International immunopharmacology 医学-免疫学

CiteScore

8.40

自引率

3.60%

发文量

935

审稿时长

53 days

期刊介绍： International Immunopharmacology is the primary vehicle for the publication of original research papers pertinent to the overlapping areas of immunology, pharmacology, cytokine biology, immunotherapy, immunopathology and immunotoxicology. Review articles that encompass these subjects are also welcome. The subject material appropriate for submission includes: • Clinical studies employing immunotherapy of any type including the use of: bacterial and chemical agents; thymic hormones, interferon, lymphokines, etc., in transplantation and diseases such as cancer, immunodeficiency, chronic infection and allergic, inflammatory or autoimmune disorders. • Studies on the mechanisms of action of these agents for specific parameters of immune competence as well as the overall clinical state. • Pre-clinical animal studies and in vitro studies on mechanisms of action with immunopotentiators, immunomodulators, immunoadjuvants and other pharmacological agents active on cells participating in immune or allergic responses. • Pharmacological compounds, microbial products and toxicological agents that affect the lymphoid system, and their mechanisms of action. • Agents that activate genes or modify transcription and translation within the immune response. • Substances activated, generated, or released through immunologic or related pathways that are pharmacologically active. • Production, function and regulation of cytokines and their receptors. • Classical pharmacological studies on the effects of chemokines and bioactive factors released during immunological reactions.