Immunotherapy rechallenge in Extensive-Stage small cell lung Cancer: A Real-World retrospective study

Area of Science:

• Oncology
• Immunotherapy
• Clinical Trials

Background:

• Extensive-stage small cell lung cancer (ES-SCLC) often develops resistance to initial immunochemotherapy.
• Limited data exists on the efficacy and safety of rechallenging with immune checkpoint inhibitors (ICIs) after first-line treatment progression in ES-SCLC.

Purpose of the Study:

• To evaluate the efficacy and safety of ICI rechallenge versus no rechallenge in ES-SCLC patients progressing after first-line immunochemotherapy.
• To identify prognostic factors associated with improved outcomes in this patient population.

Main Methods:

• Retrospective analysis of 151 ES-SCLC patients treated with first-line immunochemotherapy.
• Comparison of objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS2), overall survival (OS), and adverse events (AEs) between ICI rechallenge and non-ICI groups.

Main Results:

• ICI rechallenge significantly increased ORR (26.0% vs. 11.8%) and DCR (75.0% vs. 47.1%).
• Median PFS2 (3.98 vs. 2.43 months) and OS (9.43 vs. 6.23 months) were significantly longer in the ICI rechallenge group.
• No significant difference in grade ≥3 treatment-related adverse events; immune-related adverse events were mostly low-grade.

Conclusions:

• ICI rechallenge demonstrates significant efficacy and prognostic benefit for ES-SCLC patients post-progression on first-line immunochemotherapy.
• First-line PFS > 6 months, ICI rechallenge, and third-line therapy are independently associated with improved outcomes.
• Prospective Phase III studies are recommended to validate these findings.