Li Lingling, Liu Tingting, Liu Qingyan, Mu Shuai, Tao Haitao, Yang Xuhui, Li Yao, Xiong Qi, Wang Lijie, Hu Yi
School of Medicine, Nankai University, Tianjin, China.
Senior Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
Front Pharmacol. 2022 Sep 6;13:967559. doi: 10.3389/fphar.2022.967559. eCollection 2022.
Rechallenge of immunotherapy beyond progression (RIBP) has been demonstrably effective in a variety of cancers. Our study aims to investigate the efficacy of RIBP in small-cell lung cancer (SCLC) patients under real-world conditions. SCLC patients who experienced progressive disease after receiving programmed cell death-1 (PD-1)/programmed cell death ligand-1 (PD-L1) inhibitors combined with chemotherapy from January 2017 to October 2021 were enrolled. The study population was divided into two groups: the RIBP group and the discontinuation of immunotherapy beyond progression (DIBP) group. Inverse propensity score weighting (IPSW) method was used to balance the clinical baseline characteristics. The short-term and long-term efficacy of the two groups was compared. 100 SCLC patients were included in this study. There were 45 patients in the RIBP group and 55 patients in the DIBP group. The disease control rate (DCR) and the proportion of durable clinical benefit (DCB) were significantly higher in the RIBP group (DCR: 79.7% vs. 55.7%, = 0.027; DCB: 40.7 vs. 20.7%, = 0.025) after weighting. The median progressive-free survival (PFS) in the RIBP group was significantly longer than the DIBP group in the total population (mPFS: 4.8 vs. 2.4 months, = 0.002), while there was no significant difference in overall survival (OS) of the two groups (mOS: 17.4 vs. 8.0 months, = 0.098). In the weighted first-line initial immunotherapy subgroup, PFS and OS were significantly improved in the RIBP group (mPFS: 4.5 vs. 2.8 months, = 0.017; mOS: 11.6 vs. 5.4 months, = 0.028). After weighting, the RIBP group had a significantly longer PFS than the DIBP group in the SD/PD response to the initial immunotherapy subgroup (mPFS: 6.8 vs. 1.8 months, = 0.026). Rechallenge of PD-1/PD-L1 inhibitors could bring benefits to SCLC patients, especially in the first-line initial immunotherapy subgroup or SD/PD response to the initial immunotherapy subgroup.
超越疾病进展的免疫疗法再挑战（RIBP）已在多种癌症中被证明有效。我们的研究旨在调查RIBP在真实世界条件下对小细胞肺癌（SCLC）患者的疗效。纳入了2017年1月至2021年10月期间接受程序性细胞死亡蛋白1（PD - 1）/程序性细胞死亡配体1（PD - L1）抑制剂联合化疗后出现疾病进展的SCLC患者。研究人群分为两组：RIBP组和疾病进展后停止免疫治疗（DIBP）组。采用逆倾向评分加权（IPSW）方法平衡临床基线特征。比较两组的短期和长期疗效。本研究共纳入100例SCLC患者。RIBP组有45例患者，DIBP组有55例患者。加权后，RIBP组的疾病控制率（DCR）和持久临床获益（DCB）比例显著更高（DCR：79.7%对55.7%，P = 0.027；DCB：40.7%对20.7%，P = 0.025）。RIBP组的中位无进展生存期（PFS）在总体人群中显著长于DIBP组（mPFS：4.8个月对2.4个月，P = 0.002），而两组的总生存期（OS）无显著差异（mOS：17.4个月对8.0个月，P = 0.098）。在加权的一线初始免疫治疗亚组中，RIBP组的PFS和OS显著改善（mPFS：4.5个月对2.8个月，P = 0.017；mOS：11.6个月对5.4个月，P = 0.028）。加权后，在初始免疫治疗的稳定疾病/疾病进展（SD/PD）反应亚组中，RIBP组的PFS显著长于DIBP组（mPFS：6.8个月对1.8个月，P = 0.026）。PD - 1/PD - L1抑制剂再挑战可为SCLC患者带来益处，尤其是在一线初始免疫治疗亚组或对初始免疫治疗的SD/PD反应亚组中。
