[Durable Benefit from Immunotherapy in Advanced NSCLC: The BREATH Cohort]

Abstract

Introduction: Immune checkpoint inhibitors have revolutionized the management of advanced non-small cell lung cancer (NSCLC). While the proportion of "long-term survivors" is estimated to be between 8% and 16%, this population remains poorly understood.

Methods: BREATH is a retrospective observational study including patients with metastatic or non-radically treatable locally advanced NSCLC, treated with immunotherapy and presenting with controlled disease for at least 12 months after the first immunotherapy injection. The main objective is to describe the characteristics of this population.

Results: Forty-nine patients were included in the study. After a median follow-up of 51 months, median progression-free survival (PFS) or overall survival (OS) was not reached. At 36 months, PFS was 64.7% and OS was 91.6%. Patients who received a complete immunotherapy regimen (two years) had a higher rate of PFS (HR 0.046; 95% CI [0.14-0.98]; P=0.03) than those who received an incomplete regimen. An albumin level≥35g/L at the start of immunotherapy was the only factor associated in multivariate analysis with prolonged PFS.

Conclusion: Patients with advanced NSCLC and prolonged disease control under immunotherapy exhibit exceptionally long survival, pointing to a possible paradigm shift in our practices.

Keywords: Cancer bronchique non à petites cellules; Immunotherapy; Immunothérapie; Long survivant; Long survivors; NSCLC.