WCLC 2025 - Posters & ePosters-EP11.25 Treatment Patterns and Outcomes After First-Line Tislelizumab Progression in Advanced NSCLC: A Real-World Study

EP11.25 Treatment Patterns and Outcomes After First-Line Tislelizumab Progression in Advanced NSCLC: A Real-World Study

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This retrospective real-world study evaluated treatment patterns and outcomes in advanced non-small cell lung cancer (NSCLC) patients who progressed after first-line (1L) therapy with tislelizumab, a PD-1 immune checkpoint inhibitor widely used in China. Among 379 screened patients, 191 met eligibility criteria (advanced NSCLC, prior 1L tislelizumab, documented progression) and were categorized into three second-line (2L) treatment groups: tislelizumab-based cross-line therapy (Tisle-CLT, n=109), other ICI-based cross-line therapy (OICI-CLT, n=38), and non-ICI-based therapy (Non-ICI, n=44).<br /><br />Baseline characteristics were consistent across groups, mostly male (92%), median age 65, predominantly stage IV disease (74%), and histology mainly squamous (56%) or non-squamous (31%). At 1L, 87% received tislelizumab combined with chemotherapy, achieving a 55% objective response rate (CR/PR) and 69% durable clinical benefit (progression-free survival [PFS] ≥6 months). Progression commonly occurred in ipsilateral lung (62%) and regional lymph nodes (22%).<br /><br />Key findings show that median time to treatment failure (TTF) at 2L was significantly longer with Tisle-CLT (7.0 months) and OICI-CLT (5.1 months) versus Non-ICI (2.8 months), with hazard ratios of 0.42 and 0.55, respectively. This benefit was more pronounced in patients who had durable clinical benefit or CR/PR during 1L therapy. In those with 1L PFS ≥6 months, Tisle-CLT extended median TTF to 8.1 months versus 2.6 months in Non-ICI group. Similarly, patients responding well to 1L treatment had longer TTF when continuing ICI therapy in second line.<br /><br />The study concludes that second-line tislelizumab-based cross-line therapy may provide significant clinical benefit compared to non-ICI regimens after progression on 1L tislelizumab, especially for patients with prior good 1L response. Prospective trials are needed to confirm these findings and optimize treatment sequencing in advanced NSCLC.

Asset Subtitle

Tianqing Chu

Meta Tag

Speaker Tianqing Chu

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

advanced non-small cell lung cancer

NSCLC

tislelizumab

PD-1 immune checkpoint inhibitor

first-line therapy

second-line treatment

cross-line therapy

treatment outcomes

time to treatment failure

immune checkpoint inhibitors