2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.11A.04 Patterns of Failure and Subsequent Treatment after Progression on First-Line Immunotherapy Monotherapy in Advanced NSCLC

EP.11A.04 Patterns of Failure and Subsequent Treatment after Progression on First-Line Immunotherapy Monotherapy in Advanced NSCLC

Back to course

Pdf Summary

This study examines the progression patterns and subsequent treatment options for advanced non-small cell lung cancer (NSCLC) patients who initially received first-line anti-PD-1 monotherapy, an immune checkpoint inhibitor (ICI), from December 2017 to October 2021. The study involved 121 patients, with analyses performed on 65 with diagnostic imaging and 50 with recorded second-line treatments.<br /><br />The research identified common progression sites, noting that new lesions frequently emerged in the liver (32%), lymph nodes (16%), and bones (16%). Existing lesion failures predominantly occurred in the liver (77.8%), lung parenchyma (62.5%), and pleura (50%).<br /><br />A significant portion (56.9%) of patients experienced oligoprogression. Among them, localized progression was mostly found in the lung parenchyma and brain. More than half of these patients continued receiving ICIs post-local treatment, achieving a 2.5-year overall survival (OS) rate of 51.4%.<br /><br />The study found that anti-angiogenesis therapies might offer an optimal second-line treatment following progression on ICIs, notably improving OS. For liver progression cases in particular, anti-angiogenesis treatments extended median OS significantly (unreached compared to 6.3 months for those without, P = 0.067). Additionally, ICIs used in second-line settings showed a median OS of 21.3 months compared to 6.8 months without ICIs.<br /><br />In summary, the liver is the prevalent progression site under first-line ICI monotherapy. Anti-angiogenesis therapies are beneficial in the second-line setting, especially for liver progression, as they significantly prolong overall survival. Similarly, re-administering ICIs after localized treatments for oligoprogressive disease appears advantageous.

Asset Subtitle

Jia-Yi Deng

Meta Tag

Speaker Jia-Yi Deng

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

non-small cell lung cancer

NSCLC

immune checkpoint inhibitor

ICI

anti-PD-1 monotherapy

oligoprogression

anti-angiogenesis therapy

liver progression

overall survival

second-line treatment