WCLC 2025 - Posters & ePosters-P1.11.55 Identifying Patients Cured From Metastatic Non-Small Cell Lung Cancer (mNSCLC) With Anti-PD-(L)1 Therapy

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This multi-institutional study analyzed predictors of long-term benefit from anti-PD-(L)1 immune checkpoint inhibitor (ICI) therapies in EGFR/ALK-negative metastatic non-small cell lung cancer (mNSCLC). Despite the potential for cure, only about 10% of PD-L1 selected mNSCLC patients achieve 5-year progression-free survival (PFS). To improve patient selection and treatment optimization, researchers examined clinical and genomic factors associated with durable responses.<br /><br />Data from 3,308 mNSCLC patients treated across 10 academic centers and 3 clinical trials were stratified by response: progressive disease/stable disease, short-term responders (STR, <3 years PFS), and long-term responders (LTR, ≥3 years PFS). Treatments included anti-PD-(L)1 monotherapy, combination with chemotherapy, or dual ICI regimens.<br /><br />Tumor response was assessed by RECIST v1.1; genomic profiling involved targeted gene panels or whole-exome sequencing to evaluate nonsynonymous mutations, tumor mutational burden (TMB), copy number alterations, and specific genomic alterations. Statistical analyses included mixture cure modeling with a Weibull distribution to estimate the fraction of “cured” patients (no progression), adjusted logistic regressions, and nonparametric tests.<br /><br />Key findings indicate that clinical factors such as age, sex, histology subtype, and presence of brain/adrenal metastases did not significantly predict durable response. Data on PD-L1 expression and TMB associations with long-term benefit were noted but details not fully presented. The study highlights that only a minority of patients achieve durable responses with current ICI therapies, emphasizing the need for better biomarkers and treatment strategies.<br /><br />Overall, this work underscores the heterogeneity of response in metastatic NSCLC treated with anti-PD-(L)1 therapies and the importance of integrating clinical and genomic data to identify patients likely to achieve long-term benefit or cure. Future therapeutic approaches may focus on novel combinations and precision oncology to enhance outcomes in this population.

Asset Subtitle

Natalie Vokes

Meta Tag

Speaker Natalie Vokes

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

anti-PD-(L)1 immune checkpoint inhibitors

EGFR/ALK-negative metastatic non-small cell lung cancer

long-term responders

progression-free survival

tumor mutational burden

genomic profiling

RECIST v1.1

mixture cure modeling

treatment optimization

precision oncology