Long-Term Outcomes and Toxicities in Patients With Metastatic Non-Small Cell Lung Cancer Treated With Immunotherapy...

Area of Science:

• Oncology
• Immunotherapy
• Lung Cancer Research

Background:

• Limited data exists on acquired resistance and long-term outcomes for metastatic non-small cell lung cancer (mNSCLC) patients undergoing immunotherapy.
• This study focuses on mNSCLC patients demonstrating ongoing treatment response at two years (long-term responders).

Purpose of the Study:

• To examine the long-term outcomes of mNSCLC patients who are long-term responders to immunotherapy.
• To identify factors influencing survival and toxicities in this patient cohort.

Main Methods:

• A multi-center retrospective study of mNSCLC patients treated with first- or second-line immunotherapy ± chemotherapy.
• Progression-free survival (PFS) and overall survival (OS) were analyzed, stratified by PD-L1 tumor proportion score (TPS), treatment duration, and line of therapy.

Main Results:

• Of 354 patients, 52 (15%) were identified as long-term responders, predominantly with high PD-L1 TPS and adenocarcinoma histology.
• Median follow-up was 39 months; 3-year PFS was 78% and 3-year OS was 93%.
• Most responders achieving progression (87% oligo-progression) maintained disease control with subsequent local therapies (53%). Long-term toxicities, mainly endocrinopathies, affected 44%.

Conclusions:

• Long-term responders in mNSCLC exhibit favorable survival and sustained disease control, often with local therapies post-progression.
• Treatment duration, PD-L1 TPS, and treatment line did not significantly impact survival outcomes.
• Endocrinopathies represent common long-term toxicities requiring ongoing management.