Related Experiment Video
Updated: Aug 5, 2026
Patient-Derived Tumor Explants As a "Live" Preclinical Platform for Predicting Drug Resistance in Patients
Published on: February 7, 2021
Disease Kinetics and Practice Patterns in ≥4-Year Long-Term Beneficiaries of Immune Checkpoint Inhibitors for
Masahiro Torasawa1, Yoshihiro Masui1, Keita Miura2
1Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
Background:
Immune checkpoint inhibitors (ICIs) have enabled durable responses in a subset of patients with advanced non-small cell lung cancer (NSCLC); however, the clinical trajectories and patterns of late disease progression among long-term survivors remain poorly characterized.
Methods:
This multicenter retrospective study enrolled advanced NSCLC patients who received ICI-containing therapy between January 2015 and April 2020. Long-term beneficiaries (LTBs) were defined as patients achieving both overall survival of ≥4 years and time to next cytotoxic chemotherapy (TTNC) of ≥4 years. We performed 4-year landmark analyses, characterized late progression (first radiographic progression ≥4 years from ICI initiation), and evaluated cause-specific mortality using competing risk analysis.
Results:
Of 3,144 patients, 537 (17%) survived ≥4 years, and 295 (9.4%) were LTBs (median follow-up, 68.6 months), with only 8.1% lost to follow-up at the data cutoff. ICI was initiated as first-line therapy in 63% of the patients. Among the 235 LTBs without progression at 4 years, 66% discontinued ICI. The lung cancer-specific overall survival (OS) rates were 97.8% and 88.0% at 6 and 8 years, respectively. Late progression occurred in 26 patients (11.1%); all involved ≤5 lesions, and 84.6% of patients demonstrated indolent progression with growth speeds ≤10 mm/month. Local therapy was selected in 42% of the patients after progression. Of 22 deaths ≥4 years post-ICI, only seven (32%) were lung cancer-related, while 15 (68%) were from other causes, including secondary malignancies. Competing risk analysis showed other-cause mortality consistently exceeded lung cancer-related mortality.
Conclusions:
LTBs without progression at four years achieved durable control, with lung cancer-specific OS approaching 90% at eight years of follow-up. Late progression is uncommon, limited in extent, and often treated locally. The predominance of non-lung cancer-related mortality underscores the importance of comprehensive survivorship care.
