Related Experiment Video
Updated: Jul 4, 2025
Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
Response to immune checkpoint inhibitor combination therapy in metastatic RET-mutated lung cancer from real-world
Ningning Yan1, Huixian Zhang1, Shujing Shen2
1Department of Medical Oncology, Zhengzhou University First Affiliated Hospital, 1st East Jianshe Road, Zhengzhou, Henan, 450002, China.
Background:
The impact of immune checkpoint inhibitors (ICIs) based treatments on non-small cell lung cancers (NSCLCs) with RET fusions remains poorly understood.
Methods:
We screened patients with RET fusions at the First Affiliated Hospital of Zhengzhou University and included those who were treated with ICIs based regimens for further analysis. We evaluated clinical indicators including objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS).
Results:
A total of 232 patients with RET fusions were included in the study. Of these, 129 patients had their programmed death-ligand 1 (PDL1) expression levels tested, with 22 patients (17.8%) having a PDL1 level greater than or equal to 50%. Additionally, tumor mutational burden (TMB) status was evaluated in 35 patients, with the majority (30/35, 85.8%) having a TMB of less than 10 mutations per megabase. Out of the 38 patients treated with ICI based regimens, the median PFS was 5 months (95% confidence interval [CI]: 2.4-7.6 months) and the median OS was 19 months (95% CI: 9.7-28.3 months) at the time of data analysis. Stratification based on treatment lines did not show any significant differences in OS (18 vs. 19 months, p = 0.63) and PFS (6 vs. 5 months, p = 0.86). The ORR for patients treated with ICIs was 26.3%. Furthermore, no significant differences were found for PFS (p = 0.27) and OS (p = 0.75) between patients with positive and negative PDL1 expression. Additionally, there was no significant difference in PD-L1 levels (p = 0.10) between patients who achieved objective response and those who did not.
Conclusions:
Patients with RET fusion positive NSCLCs may not benefit from ICI based regimens and therefore should not be treated with ICIs in clinical practice.
Insights
Immune checkpoint inhibitors (ICIs) show limited benefit for non-small cell lung cancer (NSCLC) with RET fusions. Patients with RET fusion-positive NSCLC should not be treated with ICIs in clinical practice.
Area of Science:
- Oncology
- Genetics
- Immunotherapy
Background:
- Non-small cell lung cancer (NSCLC) with RET fusions represents a distinct molecular subtype.
- The efficacy of immune checkpoint inhibitors (ICIs) in this specific NSCLC population is not well-established.
- Understanding treatment outcomes is crucial for optimizing patient care.
Purpose of the Study:
- To evaluate the clinical impact of ICI-based treatments in patients with NSCLC harboring RET fusions.
- To assess objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS).
- To investigate the correlation between PD-L1 expression, tumor mutational burden (TMB), and treatment outcomes.
Main Methods:
- Retrospective analysis of 232 patients with RET fusions at the First Affiliated Hospital of Zhengzhou University.
- Inclusion of patients treated with ICI-based regimens.
- Evaluation of clinical outcomes including ORR, DCR, PFS, and OS.
- Assessment of PD-L1 expression and TMB status in relevant patient subgroups.
Main Results:
- Among 38 patients treated with ICIs, median PFS was 5 months and median OS was 19 months.
- The ORR for ICI-treated patients was 26.3%.
- No significant differences in PFS or OS were observed based on PD-L1 expression levels or treatment lines.
Conclusions:
- Patients with RET fusion-positive NSCLC demonstrated limited benefit from ICI-based treatments.
- Current clinical evidence suggests that ICIs may not be an effective treatment strategy for this patient group.
- Further research may be warranted to explore alternative therapeutic approaches for RET fusion-positive NSCLC.
Related Concept Videos
01:27Tumor Immunotherapy
02:50Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...