Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Number 17 Panjiayuan Nan Li, Chao Yang District, Beijing, 100021, China.
Department of Medical Oncology, Cancer Hospital of Huanxing, Beijing, China.
J Cancer Res Clin Oncol. 2022 Nov;148(11):3081-3089. doi: 10.1007/s00432-021-03901-2. Epub 2022 Jan 4.
After progression to immunotherapy, the standard of care for non-small cell lung cancer (NSCLC) was limited. Administration of the same or different immune checkpoint inhibitors (i.e., ICI rechallenge) may serve as a novel option. The present study aimed to evaluate the efficacy of ICI rechallenge for NSCLC and explore prognostic factors.
In this retrospective cohort study, data of advanced or metastatic NSCLC patients rechallenged with ICI at the Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College between December 2018 and June 2021 were retrieved. Progression-free, overall survivals (PFS; OS), etc. were calculated. Subgroup analyses were conducted according to baseline characteristics, prior treatment results, etc. for prognostic factor exploration using the Cox model.
Forty patients were included. Median age was 59 years. Thirty-one (78%) were male. Twenty-seven (68%) were smokers. Adenocarcinoma (28 [70%]) was the major histological subtype. Median PFS of patients receiving initial ICI was 5.7 months. The most common rechallenge regimens were ICI plus chemotherapy and/or angiogenesis inhibitor (93%). Seventeen (43%) were rechallenged with another ICI. Median PFS for ICI rechallenge was 6.8 months (95% CI 5.8-7.8). OS was immature. Tendencies for longer PFS were observed in nonsmoker or patients with adenocarcinoma, response of stable/progressive disease in initial immunotherapy, or whose treatment lines prior to ICI rechallenge were one/two. However, all results of prognostic factors were nonsignificant.
ICI rechallenge may be an option for NSCLC after progress to immunotherapy. Further studies to confirm the efficacy and investigate prognostic factors are warranted.
免疫治疗进展后，非小细胞肺癌（NSCLC）的标准治疗方法有限。使用相同或不同的免疫检查点抑制剂（即ICI 再挑战）进行治疗可能是一种新的选择。本研究旨在评估 NSCLC 患者接受 ICI 再挑战的疗效，并探讨预后因素。
这是一项回顾性队列研究，研究对象为 2018 年 12 月至 2021 年 6 月在中国医学科学院肿瘤医院和北京协和医学院接受 ICI 再挑战的晚期或转移性 NSCLC 患者。计算无进展生存期（PFS）、总生存期（OS）等。使用 Cox 模型进行亚组分析，根据基线特征、既往治疗结果等，对预后因素进行探索。
共纳入 40 例患者。中位年龄为 59 岁。31 例（78%）为男性。27 例（68%）为吸烟者。腺癌（28 例[70%]）是主要的组织学亚型。接受初始 ICI 治疗的患者中位 PFS 为 5.7 个月。最常见的再挑战方案为 ICI 联合化疗和/或血管生成抑制剂（93%）。17 例（43%）患者接受了另一种 ICI 的再挑战。ICI 再挑战的中位 PFS 为 6.8 个月（95%CI 5.8-7.8）。OS 不成熟。在初始免疫治疗中疾病稳定/进展的非吸烟者或腺癌患者、无进展生存期有延长趋势，或 ICI 再挑战前的治疗线数为 1 线/2 线的患者中，OS 也有延长趋势。然而，所有预后因素的结果均无统计学意义。
ICI 再挑战可能是免疫治疗进展后 NSCLC 的一种选择。需要进一步的研究来证实其疗效，并探讨预后因素。
