2023 World Conference on Lung Cancer (Posters)-P2.07. Factors Associated with Disease Progression after Discontinuation of Immunotherapy for Immune-Related Toxicity in Non-small Cell Lung Cancer

P2.07. Factors Associated with Disease Progression after Discontinuation of Immunotherapy for Immune-Related Toxicity in Non-small Cell Lung Cancer - PDF(Abstract)

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Researchers presented a study at the WCLC 2023 conference that aimed to identify factors associated with disease progression after discontinuation of immunotherapy for immune-related toxicity in non-small cell lung cancer (NSCLC) patients. The study analyzed clinicopathologic data from patients at two institutions who received a PD-(L)1 inhibitor or anti-CTLA4 and discontinued treatment due to immune-related adverse events (irAEs) without disease progression. <br /><br />Of the 2,794 patients treated with immunotherapy, 10% (271 patients) discontinued treatment for irAEs. The most common irAEs leading to discontinuation were colitis, pneumonitis, arthralgias/myalgias, and hepatitis. At a median follow-up of 61.0 months, the median post-discontinuation progression-free survival (PFS) was 12.8 months and the median post-discontinuation overall survival (OS) was 43.7 months. <br /><br />Factors associated with longer post-discontinuation PFS included higher PD-L1 tumor proportion score, younger age, and best response to therapy. Longer post-discontinuation OS was observed for higher PD-L1, younger age, complete/partial response, and non-squamous histology. Increasing tumor mutational burden was associated with improved PFS, but not OS. <br /><br />Treatment duration before discontinuation also played a role in post-discontinuation outcomes. Patients treated for more than 6 months before discontinuation had significantly longer PFS and OS compared to those treated for shorter durations. The use of immunosuppressive agents for immune-related toxicity management did not impact post-discontinuation outcomes.<br /><br />In conclusion, the study findings suggest that treatment duration, response achieved, PD-L1 levels, and histology can help clinicians identify NSCLC patients who may experience longer-term benefit after discontinuation of immunotherapy. These findings can guide clinicians in making informed decisions regarding the continuation or discontinuation of immunotherapy in NSCLC patients.

Asset Subtitle

Biagio Ricciuti

Meta Tag

Speaker Biagio Ricciuti

Topic Metastatic NSCLC: Immunotherapy - Retrospective

Keywords

WCLC 2023 conference

disease progression

immunotherapy

immune-related toxicity

non-small cell lung cancer

NSCLC patients

irAEs

progression-free survival

overall survival

PD-L1 levels