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04-11-2021 | Non-small-cell lung cancer | News

Real-world data support 2-year ICI duration in NSCLC

Laura Cowen

medwireNews: A high proportion of individuals with non-small-cell lung cancer (NSCLC) who complete 2 years of immune checkpoint inhibitor (ICI) treatment show durable responses after stopping treatment, show real-world data from Korea.

The majority of individuals who stop treatment after 6 months without progression also continue to respond for at least 1 year, report Myung-Ju Ahn (Sungkyunkwan University School of Medicine, Seoul, Republic of Korea) and co-authors in Cancer.

Ahn and team reviewed data for 96 patients with NSCLC who completed 2 years of ICI therapy at 11 medical centers in Korea between 2017 and 2020. Of these, 63.5% were treated with pembrolizumab, 30.2% received nivolumab, 4.2% received atezolizumab, and 2.1% were given other ICIs.

During a median 33.9 months of follow-up, 85.4% of patients had an objective response to treatment, with 6.3% achieving a complete response and 79.2% a partial response.

Median progression-free survival (PFS) and overall survival (OS) durations were not reached, but the estimated PFS and OS at 12 months after ICI cessation were 81.1% and 96.4%, respectively.

Moreover, at the time of data cutoff, 97.9% of patients were still alive and 87.5% were alive and without disease progression.

The researchers observed no significant differences in PFS or OS according to the line of treatment, type of ICI, or PD-L1 status, but note that both outcomes were significantly longer for individuals with a complete or partial response than for those with stable disease.

Ahn and colleagues also reviewed data for 43 patients who received ICIs for more than 6 months (median duration 10.5 months) and discontinued without disease progression. The main reason for discontinuation was adverse events (60.5%), followed by loss to follow-up (16.3%), patient refusal (14.0%), and financial burden (9.3%).

In this group, the objective response rate was 90.7%, and after a median 21.2 months of follow-up, median PFS and OS had not been reached.

At 12 months postdiscontinuation, the estimated PFS rate was 71.0% and the estimated OS rate was 90.0%, with 90.7% of patients alive at data cutoff and 76.7% alive and disease free.

“When we consider that 90.7% of the patients achieved a response in this cohort, these results suggest that once the patients achieved a durable response at more than 6 months, a substantial number of them experienced long-term PFS despite discontinuing ICIs,” Ahn et al remark.

The authors note that their findings are in line with those of the KEYNOTE 010 trial, previously reported by medwireNews.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group 

Cancer 2021; doi:10.1002/cncr.33984