WCLC 2025 - Posters & ePosters-P1.11.47 Clinical Outcomes of Immune Checkpoint Inhibitors Treatment for Postoperative Recurrence in Non-Small Cell Lung Cancer

P1.11.47 Clinical Outcomes of Immune Checkpoint Inhibitors Treatment for Postoperative Recurrence in Non-Small Cell Lung Cancer

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This retrospective single-center study evaluated the impact of immune checkpoint inhibitors (ICIs) on postoperative recurrence in patients with stage I-III non-small cell lung cancer (NSCLC) harboring wild-type epidermal growth factor receptor (EGFR). Among 1832 NSCLC patients undergoing lung resection between 2013-2022, 107 patients with postoperative recurrence were analyzed—73 received ICIs with or without chemotherapy (ICIs group), and 34 received only chemotherapy (non-ICIs group). Baseline characteristics, including sex, age, pathological stage, and performance status (PS), were comparable between groups, though interstitial lung disease (ILD) history was more common in the non-ICIs group (14.7% vs. 2.7%, p=0.032). PD-L1 tumor proportion score (TPS) differed significantly, with higher PD-L1 expression in the ICIs group.<br /><br />The study found ICIs treatment significantly prolonged median survival after recurrence (38.8 months vs. 16.4 months; p<0.01). This survival benefit persisted even after excluding patients with ILDs (38.9 vs. 17.2 months; p=0.02). Subgroup analysis within the ICIs group revealed no significant difference in survival according to PD-L1 status. Multivariate analysis identified initial distant metastasis (HR 1.75, 95% CI 1.01–3.03) and worse PS at recurrence (PS1 vs. PS0: HR 2.00, 95% CI 1.08–3.70) as poor prognostic factors, whereas ICIs treatment independently improved prognosis (HR 0.52, 95% CI 0.30–0.89).<br /><br />Limitations include its retrospective design, single-center scope, and incomplete PD-L1 assessment, possibly introducing selection bias. Nevertheless, the findings suggest ICIs significantly improve survival in postoperative recurrence of wild-type EGFR NSCLC, underscoring the importance of PS and metastasis status at recurrence as prognostic indicators. Further prospective studies are warranted to validate these results and optimize patient selection for ICIs post recurrence.

Asset Subtitle

Yoshito Imamura

Meta Tag

Speaker Yoshito Imamura

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

immune checkpoint inhibitors

non-small cell lung cancer

wild-type EGFR

postoperative recurrence

lung resection

chemotherapy

PD-L1 tumor proportion score

performance status

survival after recurrence

prognostic factors