Nagai Takahiro, Akamatsu Hiroaki, Takase Eri, Murakami Eriko, Sugimoto Takeya, Shibaki Ryota, Hayata Atsushi, Shimizu Toshio, Nakanishi Masanori, Koh Yasuhiro, Yamamoto Nobuyuki
Internal Medicine III, Wakayama Medical University, Wakayama, Japan.
Center for Biomedical Sciences, Wakayama Medical University, Wakayama, Japan.
Thorac Cancer. 2025 Jun;16(11):e70090. doi: 10.1111/1759-7714.70090.
Immune checkpoint inhibitors (ICI)-containing therapy for advanced or recurrent non-small cell lung cancer (NSCLC) are not completed by some responders for reasons other than progressive disease (PD). The proportion of patients who discontinue ICI and the length of their treatment-free status are unclear.
In this single-center retrospective study, we examined the medical records of 233 patients who initiated ICI-based therapy at our hospital between 2016 and 2020. We identified patients who completed treatment and discontinued it for reasons other than PD. The primary outcome was treatment-free survival, which we termed ICI-free survival.
Sixty-five patients were eligible for analysis. In the discontinuation group, the median duration of ICI was 3.9 months. Median progression-free survival, ICI-free survival, and overall survival in the entire population were 25.0, 11.5, and 78.3 months, respectively. The ICI-free survival rates at 1, 2, and 3 years were 48%, 38%, and 36%. The Kaplan-Meier curve of ICI-free survival almost reached a plateau 2 years after ICI termination. The median ICI-free survival for the completion group and discontinuation group was not reached and 9.4 months, respectively (adjusted HR 0.28, p = 0.01). Estimated ICI-free survival rates in the completion and discontinuation groups were 80% vs. 38% at 1 year, 66% vs. 30% at 2 years, and 66% vs. 28% at 3 years.
Patients who discontinued ICI therapy had poorer ICI-free survival than those who completed it. However, there was a notable population of patients with long-term ICI-free survival.
对于晚期或复发性非小细胞肺癌（NSCLC），含免疫检查点抑制剂（ICI）的治疗方案因疾病进展（PD）以外的原因，部分缓解者未完成治疗。停药的患者比例及其无治疗状态的持续时间尚不清楚。
在这项单中心回顾性研究中，我们检查了2016年至2020年间在我院开始基于ICI治疗的233例患者的病历。我们确定了完成治疗并因PD以外的原因停药的患者。主要结局是无治疗生存期，我们将其称为无ICI生存期。
65例患者符合分析条件。在停药组中，ICI的中位持续时间为3.9个月。整个人群的中位无进展生存期、无ICI生存期和总生存期分别为25.0、11.5和78.3个月。1年、2年和3年的无ICI生存率分别为48%、38%和36%。ICI停药后2年，无ICI生存期的Kaplan-Meier曲线几乎达到平台期。完成组和停药组的中位无ICI生存期分别未达到和9.4个月（校正风险比0.28，p = 0.01）。完成组和停药组1年时的估计无ICI生存率分别为80%和38%，2年时分别为66%和30%，3年时分别为66%和28%。
停用ICI治疗的患者的无ICI生存期比完成治疗的患者差。然而，有相当一部分患者有长期的无ICI生存期。
