Management of non-small cell lung cancer after 2 years of immunotherapy
- PMID: 40215940
- DOI: 10.1016/j.resmer.2025.101169
Management of non-small cell lung cancer after 2 years of immunotherapy
Abstract
Background: The optimal management strategy for metastatic or advanced-stage non-small-cell lung cancer (NSCLC) after 2 years of immune checkpoint inhibitor (ICI) remains unclear.
Methods: We conducted a single-center retrospective observational study to characterize the management of patients who received at least 2 years of ICI in the first-line setting for a metastatic or advanced-stage NSCLC.
Results: Among the 254 patients that received ICI in the first-line setting, 39 (15%) achieved 2 years of treatment (ICI in monotherapy, n = 14; ICI with chemotherapy, n = 25). ICI was discontinued after 2 years (<30 months) in 31 (79%) of the cases. During the first 2 years, 29 patients (74%) had no disease progression (2 complete radiological responses, 25 partial radiological responses, and 2 stable diseases) and 10 patients (26%) experienced at least one oligo-progression, which was treated with local ablative treatment (LAT), allowing continuation of ICI up to 2 years. A positron emission tomography (PET) scan was performed at 2 years for 37 patients (95%), revealing a complete metabolic response (CMR) in 16 individuals (43%). None of these patients progressed subsequently (median follow-up: 13 months). After 2 years of ICI, the 12-month progression-free survival was 100% in case of CMR versus 49% (95% CI, 29-91) in the absence of CMR (p = 0.00037).
Conclusions: A CMR at 2 years of ICI is associated with a favorable prognosis. Further studies are needed to better establish the role of PET scan at 2 years, the relevance of LAT and the optimal duration of ICI.
Keywords: Duration of therapy; Immune checkpoint inhibitors; Immunotherapy; Lung neoplasms; Non-small-cell lung carcinoma.
Copyright © 2025 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.
Conflict of interest statement
Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Cédric Mahiat reports a relationship with MSD France SAS that includes: consulting or advisory. Jacques Cadranel reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory. Jacques Cadranel reports a relationship with Boehringer Ingelheim Pharmaceuticals Inc that includes: consulting or advisory. Jacques Cadranel reports a relationship with Daiichi Sankyo Inc that includes: consulting or advisory. Jacques Cadranel reports a relationship with MSD France SAS that includes: consulting or advisory. Jacques Cadranel reports a relationship with Novartis Pharmaceuticals that includes: consulting or advisory. Jacques Cadranel reports a relationship with Janssen Pharmaceutical Companies of Johnson & Johnson that includes: consulting or advisory. Jacques Cadranel reports a relationship with Pfizer that includes: consulting or advisory. Jacques Cadranel reports a relationship with Sanofi that includes: consulting or advisory. Jacques Cadranel reports a relationship with Takeda Oncology that includes: consulting or advisory. Samy Houari reports a relationship with Sanofi Winthrop Industry that includes: speaking and lecture fees. Jeremy Slomka reports a relationship with Takeda Oncology that includes: paid expert testimony. Vincent Fallet reports a relationship with Bristol Myers Squibb Co that includes: consulting or advisory and speaking and lecture fees. Vincent Fallet reports a relationship with Boehringer Ingelheim Pharmaceuticals Inc that includes: consulting or advisory and travel reimbursement. Vincent Fallet reports a relationship with Takeda Oncology that includes: consulting or advisory, speaking and lecture fees, and travel reimbursement. Vincent Fallet reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory, speaking and lecture fees, and travel reimbursement. Vincent Fallet reports a relationship with Sanofi that includes: consulting or advisory and speaking and lecture fees. Vincent Fallet reports a relationship with Janssen Pharmaceuticals Inc that includes: consulting or advisory and travel reimbursement. Vincent Fallet reports a relationship with Roche that includes: consulting or advisory. Vincent Fallet reports a relationship with Pfizer France that includes: consulting or advisory, speaking and lecture fees, and travel reimbursement. Vincent Fallet reports a relationship with MSD France SAS that includes: consulting or advisory and speaking and lecture fees. Vincent Fallet reports a relationship with Novartis that includes: consulting or advisory and travel reimbursement. Vincent Fallet reports a relationship with Regeneron Pharmaceuticals Inc that includes: consulting or advisory. Vincent Fallet reports a relationship with Amgen Inc that includes: speaking and lecture fees and travel reimbursement. Vincent Fallet reports a relationship with Daiichi Sankyo Inc that includes: speaking and lecture fees. Vincent Fallet reports a relationship with Isis medical that includes: speaking and lecture fees and travel reimbursement. Vincent Fallet reports a relationship with LVL that includes: travel reimbursement. Anthony Canellas reports a relationship with Amgen Inc that includes: consulting or advisory. Anthony Canellas reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory. Anthony Canellas reports a relationship with Bristol Myers Squibb Co that includes: consulting or advisory. Anthony Canellas reports a relationship with Takeda Oncology that includes: consulting or advisory. Anthony Canellas reports a relationship with Regeneron Pharmaceuticals Inc that includes: consulting or advisory and travel reimbursement. Anthony Canellas reports a relationship with Oxyvie that includes: travel reimbursement. Anthony Canellas reports a relationship with LVL that includes: travel reimbursement. Anthony Canellas reports a relationship with Pfizer that includes: travel reimbursement. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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