2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.11A.21 Target Switching as an Effective Second-Line Strategy for Refractory Metastatic NSCLC

Pdf Summary

The study conducted by Wint Yan Arthur Aung at the Northwell Health Cancer Institute explores the efficacy of sequential PD-1/PD-L1 inhibitor therapy in treating metastatic non-small cell lung cancer (NSCLC). With NSCLC making up 80% of lung cancer cases and a significant portion diagnosed at an advanced stage, immune checkpoint inhibitors (ICIs) have transformed treatment approaches, substantially improving survival rates compared to pre-ICI therapies. However, progression after first-line (1L) treatments remains a major hurdle, and standard second-line (2L) care options are limited, often reverting to older chemotherapy methods with poor survival rates.<br /><br />The study investigates whether switching the therapeutic targets from PD-1 to PD-L1 inhibitors (or vice versa) could overcome resistance and improve outcomes. A single-center, retrospective analysis included patients treated with sequential ICI therapy from 2015 to 2022. Results indicated a median progression-free survival (PFS) of 5.6 months with the initial ICI and 4.9 months with the second ICI. Notably, in patients who continued the first ICI beyond 8 months without disease progression, the median PFS on the second ICI was extended to 8.9 months, yet no significant differences were observed based on the sequence of therapy or the reasons for discontinuing the 1L treatment.<br /><br />Although the study suggests switching inhibitors could be beneficial for patients experiencing disease progression, the findings emphasize that chemotherapy between first and second ICIs was associated with poorer outcomes. Ultimately, this underscores the potential of target-switching as a therapeutic strategy while cautioning against interposing chemotherapy between ICI therapies.

Asset Subtitle

Wint Yan Aung

Meta Tag

Speaker Wint Yan Aung

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

PD-1/PD-L1 inhibitors

metastatic NSCLC

immune checkpoint inhibitors

sequential therapy

progression-free survival

second-line treatment

chemotherapy

target-switching

therapeutic strategy

Northwell Health Cancer Institute