IN a pivotal development for the oncology community, a recent retrospective study has demonstrated that continuing immunotherapy beyond disease progression offers significant survival benefits for patients with advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). This research provides critical insights into optimizing treatment strategies for these aggressive malignancies.
The study analyzed data from 150 patients who experienced disease progression following initial treatment with immune checkpoint inhibitors (ICIs) between January 2020 and December 2023. Participants were categorized into two groups based on their second-line treatment: those who continued immunotherapy beyond progression (IBP) and those who received non-immunotherapy treatments beyond progression (NIBP). The primary objective was to compare survival outcomes and assess treatment safety between these cohorts.
Notably, among patients with driver gene-negative NSCLC, the IBP group exhibited a median progression-free survival (mPFS) of 4.7 months, compared to 1.3 months in the NIBP group (hazard ratio [HR] = 0.29, P < 0.01). Furthermore, the median overall survival (mOS) was significantly extended in the IBP group, reaching 11.03 months versus 2.63 months in the NIBP group (HR = 0.13, P < 0.001). Similarly, patients with SCLC benefited from continued immunotherapy. The IBP group achieved an mPFS of 3.9 months, while the NIBP group had an mPFS of 2.1 months (HR = 0.38, P = 0.02). The mOS for the IBP group was 9.28 months, markedly higher than the 2.27 months observed in the NIBP group (HR = 0.23, P < 0.01). An additional finding of the study highlighted that driver gene-negative NSCLC patients who achieved a partial response (PR) or stable disease (SD) during initial immunotherapy experienced improved outcomes when continuing immunotherapy beyond progression. This suggests that the initial response to ICIs may serve as a predictive marker for the efficacy of extended immunotherapy. These findings underscore the potential of sustained immunotherapy in enhancing survival outcomes for patients with advanced NSCLC and SCLC, particularly those lacking driver gene mutations. The study advocates for the consideration of continuous immunotherapy as a viable second-line treatment option in this patient population. As the oncology field advances, these insights may inform clinical decisions and guidelines, ultimately improving patient care and prognosis in advanced lung cancer cases. Reference: Cheng J et al. Continuous immunotherapy beyond disease progression in patients with advanced non-small cell and small cell lung cancer. Cancer Immunol Immunother. 2025;74(124). Anaya Malik | AMJ
