Title :

Pursuit or discontinuation of anti-PD1 after 2 years of treatment in long-term responder patients with non-small cell lung cancer.

Author(s) :

Ardin, Camille [Auteur]
Institut Coeur Poumon [CHU Lille]
Humez, Sarah [Auteur]
Service de pathologie [CHU Lille]
Leroy, Vincent [Auteur]
Ampere, Alexandre [Auteur]
Centre Hospitalier de Béthune [CH Béthune]
Bordier, Soraya [Auteur]
Narducci, Fabienne [Auteur]
Institut de Biochimie et Biologie Moléculaire [CHRU Lille]
Turlotte, Amélie [Auteur]
Groupe Hospitalier Artois-Ternois Centre Hospitalier d’Arras
Stoven, Luc [Auteur]
Centre Hospitalier Boulogne-sur-mer
Nunes, David [Auteur]
Institut Coeur Poumon [CHU Lille]
Hôpital Victor Provo [Roubaix]
Cortot, Alexis [Auteur]
Miniaturisation pour la Synthèse, l’Analyse et la Protéomique - UAR 3290 [MSAP]
Institut Coeur Poumon [CHU Lille]
Gauvain, Clément [Auteur]
Institut Coeur Poumon [CHU Lille]

Journal title :

THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY

Pages :

17588359231195600

Publisher :

SAGE Journals

Publication date :

2023-09-13

ISSN :

1758-8340

English keyword(s) :

ICI treatment duration
long-term responders
nivolumab
non-small cell lung cancer
pembrolizumab

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background:The optimal duration of immune checkpoint inhibitor (ICI) treatment for patients with advanced non-small cell lung cancer (NSCLC) remains to be determined. Treatment durations in cornerstone phase 3 clinical ...
Show more >Background:The optimal duration of immune checkpoint inhibitor (ICI) treatment for patients with advanced non-small cell lung cancer (NSCLC) remains to be determined. Treatment durations in cornerstone phase 3 clinical trials vary between a fixed 2-year duration and pursuit until disease progression. Clinical practices may thus differ according to the attending physician.Objectives:Here we provide real-world data about treatment decisions at 2 years, with subsequent clinical outcomes.Design and Methods:This multicentric observational study included patients with advanced NSCLC whose disease was controlled after 2 years of pembrolizumab or nivolumab. The primary outcome was the decision to discontinue ICI treatment or not, along with factors motivating this decision. Secondary outcomes included progression-free survival (PFS) (according to treatment continuation or not) and adverse events.Results:A total of 91 patients were included, of which 60 (66%) had been pre-treated. The programmed death-ligand 1 expression level was ⩾50% in 43 patients (47%). In 61 patients (67%), ICI was continued after 2 years of treatment. This decision was significantly associated with the care center (p < 0.001) but neither with the tumor response at 2 years, as evaluated by CT scan or PET scan, nor with clinical status, immune-related adverse events, or previous locally treated oligo-progressive disease under ICI. Two years after the 2-year decision, PFS was 68.5%, [95% confidence interval (CI) (53.3–88.0)] in the ‘ICI discontinuation’ group and 64.1% [95% CI (51.9–79.2)] in the ‘ICI pursuit’ group; hazard ratio for relapse was 1.14 [95% CI (0.54–2.30), p = 0.77]. The overall survival rate at 24 months after discontinuation was 89.2% [95% CI (78.4–100)] for the ‘discontinuation’ group and 93.1% [95% CI (85.8–100)] for the ‘pursuit’ group. Given insufficient power, overall survival could not be compared.Conclusion:The decision to continue ICI or not after 2 years of treatment depends mainly on the care center and does not seem to impact survival. Larger, randomized data sets are required to confirm this result.Show less >

Language :

Anglais

Popular science :

Non

Collections :

• Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP) - USR 3290

Source :

Harvested from HAL

Submission date :

2024-07-09T03:36:05Z