Abstract 26P
Background
Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape for advanced non-small cell lung cancer (NSCLC), enhancing progression-free survival (PFS) and overall survival (OS). However, the optimal duration of immunotherapy (IT) remains uncertain. We aim to evaluate the impact of prolonged first-line ICIs treatment ± concurrent chemotherapy (ChT), in advanced NSCLC.
Methods
This retrospective study analyzed NSCLC patients (pts) receiving first-line ICIs ± ChT at Fondazione IRCCS Istituto Nazionale dei Tumori di Milano (2016–2022), categorized into three cohorts: progression (PD) within two years, Extended Therapy (ET) beyond two years, and Fixed-Duration (FD) therapy discontinued at two years. Kaplan-Meier and Cox models assessed PFS, while Fisher’s exact test evaluated baseline characteristics and residual disease.
Results
Among the 333-pts included, 52 (15,6%) completed two years without progression. Compared to PD pts, no differences in terms of gender (p=0.749), smoking status (p=1), cancer-related comorbidities (p=0.084), median age (p=1), type of therapy (IO vs ChT-IT; p=0.520), and extra-oncologic comorbidities (p=1) were found, while PD pts had poorer ECOG PS (p < 0.001). Sixteen patients (30.8%; IO 63%, ChT-IT 37%) were in the FD cohort, and 36 (69.2%; IO 61%, ChT-IT 39%) in the ET cohort. No significant differences were observed in therapy type (p=1), disease burden (>3 sites vs
Conclusions
This study found no significant PFS differences between the FD and ET groups, suggesting that extending immunotherapy beyond two years may not confer additional survival benefits. PET imaging was more frequently employed in the FD group. However, its actual utility in therapeutic decision-making in this setting requires further investigation.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
L. Mazzeo: Other, Personal, Other, honoraria: novartis; Other, Personal, Other, Conference Grants: Daiichi Sankyo; Financial Interests, Personal, Other, Conference Grants: LEOPharma, Sanofi. A. Prelaj: Financial Interests, Personal, Other, Training of personnel: AstraZeneca, Italfarma; Financial Interests, Personal, Invited Speaker, The Hive Project: Discussant: Roche; Financial Interests, Personal, Advisory Board, Advisory board in Lung Cancer project: BMS; Financial Interests, Personal, Other, Travel Grant: Janssen; Financial Interests, Personal, Advisory Board: Janssen, AstraZeneca; Financial Interests, Personal, Invited Speaker: Medsir, Novartis, Lilly; Financial Interests, Institutional, Invited Speaker: Bayer, BMS, AstraZeneca, Lilly, MSD, Spectrum, Roche. C. Proto: Financial Interests, Personal, Other, fees for travel, accommodation, and expenses; research funding and consulting or advisory fees: AstraZeneca, MSD; Financial Interests, Personal, Other, fees for travel, accommodation, and expenses; research funding and consulting or advisory fees: Roche; Financial Interests, Personal, Other, research funding and consulting or advisory fees: BMS; Financial Interests, Personal, Other, consulting or advisory fees: Janssen; Financial Interests, Personal, Other, research funding: Pfizer, Celgene, Daiichi Sankyo. G. Lo Russo: Financial Interests, Personal, Advisory Board: MSD, Novartis, AstraZeneca, BMS, Sanofi, Pfizer, Roche, Lilly, GSK, Daiichi, Johnson and Johnson, Regeneron, Merck, Pierre Fabre; Financial Interests, Personal, Invited Speaker: Italfarmaco, Merck, BMS, Lilly, Sanofi; Financial Interests, Institutional, Other, contribute for meeting organization: Janssen; Financial Interests, Institutional, Other, contribute for meeting organization: Bayer; Financial Interests, Personal, Other, travel accommodation: Amgen, MSD; Financial Interests, Institutional, Other, Contribute to meeting organization: Beigene; Financial Interests, Institutional, Invited Speaker: MSD, BMS, Roche, GSK, Celgene, Novartis, AstraZeneca, Amgen, Lilly. All other authors have declared no conflicts of interest.