Meghana Maddula, Lauren J. Brown, Venessa Chin, Bo Gao, Ines Pires Da Silva, Adnan Nagrial
{"title":"转移性非小细胞肺癌患者接受含免疫疗法治疗的长期预后和毒性","authors":"Meghana Maddula, Lauren J. Brown, Venessa Chin, Bo Gao, Ines Pires Da Silva, Adnan Nagrial","doi":"10.1002/cnr2.70361","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Immunotherapy is well-established in treating metastatic non-small cell lung cancer (mNSCLC); however, data regarding acquired resistance and long-term outcomes are limited. We examined long-term outcomes in mNSCLC patients with ongoing treatment response at 2 years (long-term responders) post-treatment commencement.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This multi-center retrospective study identified mNSCLC patients treated with first- or second-line immunotherapy±chemotherapy. Endpoints included progression-free survival (PFS) and overall survival (OS), stratified by PD-L1 tumor proportion score (TPS) (< 50% vs. ≥ 50%), treatment duration, and treatment line.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of 354 patients, 52 (15%) long-term responders were identified for analysis. Among them, median age was 68.5 years (28–87); the majority had an ECOG performance status ≤ 1 (81%), high-PD-L1 TPS (52%), and adenocarcinoma histopathology (83%). Most (73%) received immunotherapy first-line. Median treatment duration was 23.5 months (1–80), and 19% prematurely ceased treatment. With a median follow-up of 39 months from treatment commencement (95% CI 37–49), 15 (29%) patients had progressive disease, and 3-year PFS was 78%. Oligo-progression was common (87%), with lung/pleural disease (53%). Most received subsequent treatment (local therapy alone: 53%, systemic therapy alone: 20%, combined: 20%, supportive care: 7%) and achieved disease control (86%). Long-term toxicities occurred in 44% and were predominantly endocrinopathies (83%) requiring ongoing management. Three-year OS was 93%. Survival outcomes were unaffected by treatment duration, PD-L1 TPS, and treatment line.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Long-term responders showed favorable survival outcomes, with most maintaining disease control with local therapies even after progression. This held true regardless of treatment duration, PD-L1 TPS, or treatment line. Endocrinopathies were common long-term toxicities.</p>\n </section>\n </div>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"8 10","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnr2.70361","citationCount":"0","resultStr":"{\"title\":\"Long-Term Outcomes and Toxicities in Patients With Metastatic Non-Small Cell Lung Cancer Treated With Immunotherapy Containing Regimens\",\"authors\":\"Meghana Maddula, Lauren J. Brown, Venessa Chin, Bo Gao, Ines Pires Da Silva, Adnan Nagrial\",\"doi\":\"10.1002/cnr2.70361\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Immunotherapy is well-established in treating metastatic non-small cell lung cancer (mNSCLC); however, data regarding acquired resistance and long-term outcomes are limited. We examined long-term outcomes in mNSCLC patients with ongoing treatment response at 2 years (long-term responders) post-treatment commencement.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This multi-center retrospective study identified mNSCLC patients treated with first- or second-line immunotherapy±chemotherapy. Endpoints included progression-free survival (PFS) and overall survival (OS), stratified by PD-L1 tumor proportion score (TPS) (< 50% vs. ≥ 50%), treatment duration, and treatment line.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of 354 patients, 52 (15%) long-term responders were identified for analysis. Among them, median age was 68.5 years (28–87); the majority had an ECOG performance status ≤ 1 (81%), high-PD-L1 TPS (52%), and adenocarcinoma histopathology (83%). Most (73%) received immunotherapy first-line. Median treatment duration was 23.5 months (1–80), and 19% prematurely ceased treatment. With a median follow-up of 39 months from treatment commencement (95% CI 37–49), 15 (29%) patients had progressive disease, and 3-year PFS was 78%. Oligo-progression was common (87%), with lung/pleural disease (53%). Most received subsequent treatment (local therapy alone: 53%, systemic therapy alone: 20%, combined: 20%, supportive care: 7%) and achieved disease control (86%). Long-term toxicities occurred in 44% and were predominantly endocrinopathies (83%) requiring ongoing management. Three-year OS was 93%. Survival outcomes were unaffected by treatment duration, PD-L1 TPS, and treatment line.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Long-term responders showed favorable survival outcomes, with most maintaining disease control with local therapies even after progression. This held true regardless of treatment duration, PD-L1 TPS, or treatment line. 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Long-Term Outcomes and Toxicities in Patients With Metastatic Non-Small Cell Lung Cancer Treated With Immunotherapy Containing Regimens
Introduction
Immunotherapy is well-established in treating metastatic non-small cell lung cancer (mNSCLC); however, data regarding acquired resistance and long-term outcomes are limited. We examined long-term outcomes in mNSCLC patients with ongoing treatment response at 2 years (long-term responders) post-treatment commencement.
Methods
This multi-center retrospective study identified mNSCLC patients treated with first- or second-line immunotherapy±chemotherapy. Endpoints included progression-free survival (PFS) and overall survival (OS), stratified by PD-L1 tumor proportion score (TPS) (< 50% vs. ≥ 50%), treatment duration, and treatment line.
Results
Of 354 patients, 52 (15%) long-term responders were identified for analysis. Among them, median age was 68.5 years (28–87); the majority had an ECOG performance status ≤ 1 (81%), high-PD-L1 TPS (52%), and adenocarcinoma histopathology (83%). Most (73%) received immunotherapy first-line. Median treatment duration was 23.5 months (1–80), and 19% prematurely ceased treatment. With a median follow-up of 39 months from treatment commencement (95% CI 37–49), 15 (29%) patients had progressive disease, and 3-year PFS was 78%. Oligo-progression was common (87%), with lung/pleural disease (53%). Most received subsequent treatment (local therapy alone: 53%, systemic therapy alone: 20%, combined: 20%, supportive care: 7%) and achieved disease control (86%). Long-term toxicities occurred in 44% and were predominantly endocrinopathies (83%) requiring ongoing management. Three-year OS was 93%. Survival outcomes were unaffected by treatment duration, PD-L1 TPS, and treatment line.
Conclusions
Long-term responders showed favorable survival outcomes, with most maintaining disease control with local therapies even after progression. This held true regardless of treatment duration, PD-L1 TPS, or treatment line. Endocrinopathies were common long-term toxicities.
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