Continuous immunotherapy beyond disease progression in patients with advanced non-small cell and small cell lung cancer

Abstract Background The benefits of continuing immunotherapy beyond disease progression in advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) remain uncertain, along with the specific patient subgroups that may gain the most from this approach. This retrospective study aim...

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Main Authors: Jing Cheng, Wenwen Kang, Yueying Chen, Luyun Pan, Hedong Han, Tangfeng Lv
Format: Article
Language:English
Published: Springer 2025-02-01
Series:Cancer Immunology, Immunotherapy
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Online Access:https://doi.org/10.1007/s00262-025-03958-9
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author Jing Cheng
Wenwen Kang
Yueying Chen
Luyun Pan
Hedong Han
Tangfeng Lv
author_facet Jing Cheng
Wenwen Kang
Yueying Chen
Luyun Pan
Hedong Han
Tangfeng Lv
author_sort Jing Cheng
collection DOAJ
description Abstract Background The benefits of continuing immunotherapy beyond disease progression in advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) remain uncertain, along with the specific patient subgroups that may gain the most from this approach. This retrospective study aims to evaluate the efficacy of this approach and identify target patient populations likely to benefit. Methods We collected data from patients with NSCLC and SCLC who experienced disease progression following initial immune checkpoint inhibitor (ICI) treatment from January 2020 to December 2023. Patients were categorized based on second-line treatment: those receiving immunotherapy beyond progression (IBP) and those receiving non-immunotherapy beyond progression (NIBP). Survival outcomes and treatment safety were compared between these two groups. Results A total of 150 patients were included, with 111 NSCLC patients (IBP: n = 78, NIBP: n = 33) and 39 SCLC patients (IBP: n = 31, NIBP: n = 8). Significant differences in median progression-free survival (PFS) and overall survival (OS) were found in patients with driver gene-negative NSCLC (mPFS: 4.7 vs 1.3 months, HR = 0.29, P < 0.01; mOS: 11.03 vs 2.63 months, HR = 0.13, P < 0.001) and SCLC (mPFS: 3.9 vs 2.1 months, HR = 0.38, P = 0.02; mOS: 9.28 vs 2.27 months, HR = 0.23, P < 0.01). Additionally, among driver gene-negative NSCLC patients, achieving a partial response (PR) or stable disease (SD) during initial immunotherapy was associated with improved effectiveness of continued immunotherapy beyond progression. Conclusions Continued immunotherapy as a second-line treatment may benefit patients with driver gene-negative NSCLC and SCLC who have progressed after initial immunotherapy.
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spelling doaj-art-5c12d8c0ffe84e50bf4df79a1a6bebee2025-08-20T02:49:35ZengSpringerCancer Immunology, Immunotherapy1432-08512025-02-0174411210.1007/s00262-025-03958-9Continuous immunotherapy beyond disease progression in patients with advanced non-small cell and small cell lung cancerJing Cheng0Wenwen Kang1Yueying Chen2Luyun Pan3Hedong Han4Tangfeng Lv5Department of Respiratory and Critical Care Medicine, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Respiratory and Critical Care Medicine, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Respiratory and Critical Care Medicine, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Respiratory and Critical Care Medicine, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Respiratory and Critical Care Medicine, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Respiratory and Critical Care Medicine, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing UniversityAbstract Background The benefits of continuing immunotherapy beyond disease progression in advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) remain uncertain, along with the specific patient subgroups that may gain the most from this approach. This retrospective study aims to evaluate the efficacy of this approach and identify target patient populations likely to benefit. Methods We collected data from patients with NSCLC and SCLC who experienced disease progression following initial immune checkpoint inhibitor (ICI) treatment from January 2020 to December 2023. Patients were categorized based on second-line treatment: those receiving immunotherapy beyond progression (IBP) and those receiving non-immunotherapy beyond progression (NIBP). Survival outcomes and treatment safety were compared between these two groups. Results A total of 150 patients were included, with 111 NSCLC patients (IBP: n = 78, NIBP: n = 33) and 39 SCLC patients (IBP: n = 31, NIBP: n = 8). Significant differences in median progression-free survival (PFS) and overall survival (OS) were found in patients with driver gene-negative NSCLC (mPFS: 4.7 vs 1.3 months, HR = 0.29, P < 0.01; mOS: 11.03 vs 2.63 months, HR = 0.13, P < 0.001) and SCLC (mPFS: 3.9 vs 2.1 months, HR = 0.38, P = 0.02; mOS: 9.28 vs 2.27 months, HR = 0.23, P < 0.01). Additionally, among driver gene-negative NSCLC patients, achieving a partial response (PR) or stable disease (SD) during initial immunotherapy was associated with improved effectiveness of continued immunotherapy beyond progression. Conclusions Continued immunotherapy as a second-line treatment may benefit patients with driver gene-negative NSCLC and SCLC who have progressed after initial immunotherapy.https://doi.org/10.1007/s00262-025-03958-9Non-small cell lung cancer (NSCLC)Small cell lung cancer (SCLC)Immune checkpoint inhibitors (ICIs)Immunotherapy beyond progression (IBP)Efficacy
spellingShingle Jing Cheng
Wenwen Kang
Yueying Chen
Luyun Pan
Hedong Han
Tangfeng Lv
Continuous immunotherapy beyond disease progression in patients with advanced non-small cell and small cell lung cancer
Cancer Immunology, Immunotherapy
Non-small cell lung cancer (NSCLC)
Small cell lung cancer (SCLC)
Immune checkpoint inhibitors (ICIs)
Immunotherapy beyond progression (IBP)
Efficacy
title Continuous immunotherapy beyond disease progression in patients with advanced non-small cell and small cell lung cancer
title_full Continuous immunotherapy beyond disease progression in patients with advanced non-small cell and small cell lung cancer
title_fullStr Continuous immunotherapy beyond disease progression in patients with advanced non-small cell and small cell lung cancer
title_full_unstemmed Continuous immunotherapy beyond disease progression in patients with advanced non-small cell and small cell lung cancer
title_short Continuous immunotherapy beyond disease progression in patients with advanced non-small cell and small cell lung cancer
title_sort continuous immunotherapy beyond disease progression in patients with advanced non small cell and small cell lung cancer
topic Non-small cell lung cancer (NSCLC)
Small cell lung cancer (SCLC)
Immune checkpoint inhibitors (ICIs)
Immunotherapy beyond progression (IBP)
Efficacy
url https://doi.org/10.1007/s00262-025-03958-9
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