Gu Xinyue, Hu Yue, Mungur Ishanee Devi, Gu Feifei, Xiong Ying, Cui Jin, Zhong Luhui, Zhang Kai, Liu Li
Cancer Center, Institute of Radiation Oncology, Hubei Key Laboratory of Precision Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China.
Accident and Emergency Department, New Souillac Hospital, Souillac, Savanne 61801, Mauritius.
Oncol Lett. 2024 Dec 5;29(2):90. doi: 10.3892/ol.2024.14836. eCollection 2025 Feb.
Immunotherapy has paved the way for new treatment options for advanced non-small cell lung cancer (NSCLC). However, for patients who have progressed following first-line immunotherapy combined with chemotherapy, little is known about the benefits of the continuation of immunotherapy. Thus, the current study aimed to evaluate the efficacy of immunotherapy beyond progression (IBP) in patients with advanced NSCLC. A retrospective review of patients with advanced NSCLC who experienced disease progression after receiving a combination of ICIs and chemotherapy was conducted. Kaplan-Meier survival analysis was used to estimate progression-free survival (PFS) and overall survival (OS) times, and log-rank tests were employed to compare inter-group differences. Cox regression analyses were performed to identify independent factors associated with OS and PFS. In total, 136 patients who had disease progression after prior immunotherapy were included. A comparison of patients who were treated with ICIs after disease progression (IBP group) and those who received other treatments (non-IBP group) demonstrated a higher disease control rate after second-line treatment for the IBP group (89.8 vs. 70.8%, respectively; P=0.005). Kaplan-Meier curve analysis showed statistical differences in PFS2 (interval from the second-line treatment to progression or death for any reason; P=0.012) and OS (P=0.041). Subgroup analyses indicated superior clinical outcomes for the IBP group. Multivariate analyses revealed IBP to be an independent factor associated with improved PFS2 (hazard ratio, 0.613; 95% confidence interval, 0.403-0.933; P=0.022). In conclusion, favorable clinical outcomes for IBP were observed, and IBP remains a viable choice for patients with advanced NSCLC.
免疫疗法为晚期非小细胞肺癌（NSCLC）的新治疗选择铺平了道路。然而，对于一线免疫疗法联合化疗后病情进展的患者，继续进行免疫疗法的益处知之甚少。因此，本研究旨在评估晚期NSCLC患者免疫疗法超越疾病进展（IBP）的疗效。对接受免疫检查点抑制剂（ICIs）和化疗联合治疗后出现疾病进展的晚期NSCLC患者进行了回顾性研究。采用Kaplan-Meier生存分析来估计无进展生存期（PFS）和总生存期（OS），并使用对数秩检验来比较组间差异。进行Cox回归分析以确定与OS和PFS相关的独立因素。总共纳入了136例先前免疫治疗后病情进展的患者。对疾病进展后接受ICIs治疗的患者（IBP组）和接受其他治疗的患者（非IBP组）进行比较，结果显示IBP组二线治疗后的疾病控制率更高（分别为89.8%和70.8%；P=0.005）。Kaplan-Meier曲线分析显示，PFS2（从二线治疗到因任何原因进展或死亡的间隔时间；P=0.012）和OS（P=0.041）存在统计学差异。亚组分析表明IBP组具有更好的临床结局。多因素分析显示，IBP是与PFS2改善相关的独立因素（风险比，0.613；95%置信区间，0.403-0.933；P=0.022）。总之，观察到IBP具有良好的临床结局，对于晚期NSCLC患者，IBP仍然是一种可行的选择。
