Addition of Immune Checkpoint Inhibitor to Platinum Retreatment for Recurrent Non-Small Cell Lung Cancer After...

The addition of immune checkpoint inhibitor (ICI) to platinum-based chemotherapy has improved outcomes in patients with advanced non-small cell lung cancer (NSCLC). However, evidence on the efficacy of adding ICI to platinum retreatment in patients who relapse after perioperative platinum-based chemotherapy remains limited.

We retrospectively analyzed patients with recurrent NSCLC following perioperative platinum-based chemotherapy. Patients were categorized into either the "chemo group," who received platinum retreatment without ICI, or the "ICI-chemo group," who received platinum retreatment with ICI. The primary endpoint was progression-free survival in patients treated with ICI.

Among 124 patients who received perioperative platinum therapy and surgery, 31 underwent platinum retreatment: 17 in the chemo group and 14 in the ICI-chemo group. PFS was significantly longer in the ICI-chemo group than in the chemo group (15.4 vs. 5.9 months; log-rank p = 0.023; HR 0.40, 95% CI, 0.18-0.90). Among patients with PD-L1 ≥ 50%, the ICI-chemo group showed a greater trend toward longer PFS compared with the chemo group (16.9 vs. 4.0 months; HR 0.11, 95% CI, 0.01-1.05).

Adding ICI to platinum retreatment may be an effective option for patients with NSCLC who relapse after perioperative chemotherapy, particularly in those with PD-L1 expression ≥ 50%.