Related Experiment Video
Updated: Aug 6, 2026
Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
Prognostic significance of continuing immunotherapy beyond progression in unresectable lung adenocarcinoma
Fang Hu1,2, Liang Zheng1, Haoming Xu1
1Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background:
In patients with unresectable lung adenocarcinoma, whether cross-line immunotherapy (CIT) can improve clinical outcomes remains unclear.
Methods:
This study enrolled patients with unresectable lung adenocarcinoma who received immune checkpoint inhibitors (ICIs)-based therapy and subsequently experienced disease progression. According to post-progression treatment strategies, patients were categorized into two groups: CIT group and Non-CIT group. The primary endpoints were second progression-free survival (PFS2), overall survival (OS), and post-progression survival (PPS), analyzed both using unadjusted and inverse probability for treatment weighting (IPTW) analyses. Survival outcomes were analyzed using the Kaplan-Meier method and compared with the log-rank test. Multivariate Cox regression was performed to identify independent prognostic factors. A nomogram for PPS prediction was built and internally validated with bootstrap resampling and receiver operating characteristic (ROC) curves.
Results:
A total of 185 patients met the inclusion criteria and were studied assessed, including 77 in the CIT group and 108 in the Non-CIT group. Baseline characteristics were generally balanced between two groups. After IPTW adjustment, median PFS2 was significantly longer in the CIT group compared with the Non-CIT group (6.3 vs. 2.8 months; hazard ratio (HR)=0.54, 95% confidence intervals (CI): 0.39-0.77, P<0.001). Similarly, the CIT group demonstrated improved median PPS and OS compared with Non-CIT group. Multivariate Cox analysis also identified CIT as independent predictors of PFS2, PPS and OS. The PPS nomogram showed good predictive performance.
Conclusions:
In patients with unresectable lung adenocarcinoma who progressed after initial immunotherapy, continuation of immunotherapy beyond progression was associated with significantly improved survival. The PPS nomogram may facilitate risk stratification and personalized post-progression management.
