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Prognostic factors in patients with advanced non-small cell lung cancer after long-term Anti-PD-1 therapy (HOT1902)

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Title: Prognostic factors in patients with advanced non-small cell lung cancer after long-term Anti-PD-1 therapy (HOT1902)
Authors: Ito, Shotaro Browse this author
Asahina, Hajime Browse this author
Honjo, Osamu Browse this author
Tanaka, Hisashi Browse this author
Honda, Ryoichi Browse this author
Oizumi, Satoshi Browse this author
Nakamura, Keiichi Browse this author
Takamura, Kei Browse this author
Hommura, Fumihiro Browse this author
Kawai, Yasutaka Browse this author
Ito, Kenichiro Browse this author
Sukoh, Noriaki Browse this author
Yokoo, Keiki Browse this author
Morita, Ryo Browse this author
Harada, Toshiyuki Browse this author
Takashina, Taichi Browse this author
Goda, Tomohiro Browse this author
Dosaka-Akita, Hirotoshi Browse this author →KAKEN DB
Isobe, Hiroshi Browse this author
Keywords: Immune checkpoint inhibitor
Non-small cell lung cancer
ICI rechallenge
Issue Date: Jun-2021
Publisher: Elsevier
Journal Title: Lung cancer
Volume: 156
Start Page: 12
End Page: 19
Publisher DOI: 10.1016/j.lungcan.2021.04.011
Abstract: Objectives: Limited information is available on the appropriate treatment duration of immune checkpoint inhibitors (ICIs). We aimed to identify candidates who would benefit from ICI discontinuation after one year of treatment for metastatic non-small cell lung cancer (NSCLC). Materials and methods: This retrospective multi-institutional observational study examined medical records of all consecutive patients with advanced or recurrent NSCLC, who started ICI monotherapy at 15 institutions in Japan between December 2015 and December 2017. Patients who received initial ICI therapy for >1 year without progressive disease were defined as the long-term treatment (LT) group; others were defined as the non -longterm treatment (NLT) group. Primary outcomes included the prognostic factors in the LT group, whereas secondary outcomes included efficacy of ICI rechallenge, safety, and survival outcomes in the overall population. Results: In total, 676 patients were enrolled, and 114 (16.9 %) were assigned to the LT group. The median time interval from the start of initial ICI administration to data cutoff was 34.3 months (range, 24.1 & ndash;47.8); thus, all surviving patients were followed-up for at least 2 years from the start of initial ICI. Median progression-free survival (PFS) was longer in the LT than in the NLT group (33.6 months vs. 2.7 months; p < 0.001). On multivariate analysis, significantly better PFS was associated with smoking (hazard ratio [HR]=0.36, p = 0.04), and complete response (CR; HR=uncomputable, p < 0.001) in the LT group. Thirty-seven patients (5.5 %) received ICI rechallenge, including 10 in the LT group. Among patients receiving rechallenge treatment, the median PFS was 2.2 months, with no difference between the LT and NLT groups. Conclusions: In the LT group, smoking and achieving CR were significantly associated with better PFS. Since rechallenge treatment was not effective, careful consideration is required for discontinuing ICI. However, these prognostic factors are helpful in considering candidates for ICI discontinuation. Trial Registration: UMIN ID, UMIN000041403
Rights: ©2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 朝比奈 肇

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