Impact of Immune Checkpoint Inhibitors and Local Radical Treatment on Survival Outcomes in Synchronous Oligometastatic NSCLC
Introduction: The impact of an immune checkpoint inhibitor (ICI)–based systemic treatment strategy with or without local radical treatment (LRT) on outcomes for patients with NSCLC and synchronous oligometastatic disease (sOMD) is unknown. Methods: Multicenter retrospective study including adequatel...
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Elsevier
2025-03-01
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| Series: | JTO Clinical and Research Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364325000062 |
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| author | Mandy Jongbloed, MD Valentina Bartolomeo, MD Martina Bortolot, MD Shahan Darwesh, MD Jarno W.J. Huijs, MD Safiye Dursun, MD Juliette Degens, MD, PhD Ben E.E.M. van den Borne, MD, PhD Maggy Youssef-El Soud, MD, PhD Marcel Westenend, MD, PhD Cordula Pitz, MD, PhD Dirk K.M. De Ruysscher, MD, PhD Lizza E.L. Hendriks, MD, PhD |
| author_facet | Mandy Jongbloed, MD Valentina Bartolomeo, MD Martina Bortolot, MD Shahan Darwesh, MD Jarno W.J. Huijs, MD Safiye Dursun, MD Juliette Degens, MD, PhD Ben E.E.M. van den Borne, MD, PhD Maggy Youssef-El Soud, MD, PhD Marcel Westenend, MD, PhD Cordula Pitz, MD, PhD Dirk K.M. De Ruysscher, MD, PhD Lizza E.L. Hendriks, MD, PhD |
| author_sort | Mandy Jongbloed, MD |
| collection | DOAJ |
| description | Introduction: The impact of an immune checkpoint inhibitor (ICI)–based systemic treatment strategy with or without local radical treatment (LRT) on outcomes for patients with NSCLC and synchronous oligometastatic disease (sOMD) is unknown. Methods: Multicenter retrospective study including adequately staged patients, with sOMD NSCLC (maximum five metastases in three organs [European Organization for Research and Treatment of Cancer definition]) between January 1, 2015 and December 31, 2022, treated with a first-line ICI-based versus chemotherapy-only regimen. Primary end points were progression-free survival and overall survival (OS) for an ICI-based versus chemotherapy-only strategy. Subgroup analyses were performed for patients who were deemed candidates for LRT in the multidisciplinary meeting and those proceeding to LRT. Results: A total of 416 patients were included, treated with chemotherapy-ICI (n = 138) or chemotherapy-only (n = 278), 319 out of 416 were deemed candidates by multidisciplinary meetings for LRT, whereas 192 (60%) proceeded to LRT. The median OS was significantly longer in the chemotherapy-ICI compared with the chemotherapy-only group (33.6 versus 15.9 mo, hazard ratio [HR] = 0.5, 95% confidence interval [CI]: 0.4–0.7, p < 0.001), in the subgroups who were candidate for LRT (36.1 versus 17.2 mo, HR = 0.5, 95% CI: 0.4–0.7, p < 0.001) and those proceeding to LRT (not reached versus 23.1 mo, HR = 0.4, 95% CI: 0.2–0.7, p < 0.001). In multivariate analysis, an ICI-based strategy was associated with improved survival in the total group (HR = 0.6, 95% CI: 0.4–0.9, p < 0.001), in those with intention of LRT (HR = 0.6, 95% CI: 0.4–0.9, p = 0.02) and those who proceeded to LRT (HR = 0.3, 95% CI: 0.1–0.6, p = 0.002). Conclusions: An ICI-based systemic treatment strategy (±LRT) is associated with improved survival compared with chemotherapy-only (±LRT) for patients with sOMD NSCLC. Prospective randomized trial data are necessary to identify patients most likely to benefit from adding LRT. |
| format | Article |
| id | doaj-art-de578018cd1a4b68bfdf31f5f5cb4e30 |
| institution | Kabale University |
| issn | 2666-3643 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj-art-de578018cd1a4b68bfdf31f5f5cb4e302025-02-05T04:32:41ZengElsevierJTO Clinical and Research Reports2666-36432025-03-0163100790Impact of Immune Checkpoint Inhibitors and Local Radical Treatment on Survival Outcomes in Synchronous Oligometastatic NSCLCMandy Jongbloed, MD0Valentina Bartolomeo, MD1Martina Bortolot, MD2Shahan Darwesh, MD3Jarno W.J. Huijs, MD4Safiye Dursun, MD5Juliette Degens, MD, PhD6Ben E.E.M. van den Borne, MD, PhD7Maggy Youssef-El Soud, MD, PhD8Marcel Westenend, MD, PhD9Cordula Pitz, MD, PhD10Dirk K.M. De Ruysscher, MD, PhD11Lizza E.L. Hendriks, MD, PhD12Department of Pulmonary Diseases, GROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The NetherlandsRadiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical Surgical, Diagnostic and Pediatric Sciences, Pavia University, Pavia, Italy; Department of Radiation Oncology (Maastro Clinic), Maastricht University Medical Center, GROW – Research Institute for Oncology and Reproduction, Maastricht, The NetherlandsDepartment of Medicine (DMED), University of Udine, Udine, ItalyDepartment of Pulmonary Diseases, GROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The NetherlandsDepartment of Pulmonary Diseases, GROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The NetherlandsDepartment of Pulmonary Diseases, GROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The NetherlandsDepartment of Pulmonary Diseases, Zuyderland Hospital, Heerlen, The NetherlandsDepartment of Pulmonary Diseases, Catharina Hospital, Eindhoven, The NetherlandsDepartment of Pulmonary Diseases, Maxima Medical Center, Eindhoven, The NetherlandsDepartment of Pulmonary Diseases, Viecuri hospital, Venlo, The NetherlandsDepartment of Pulmonary Diseases, Laurentius hospital, Roermond, The NetherlandsDepartment of Radiation Oncology (Maastro Clinic), Maastricht University Medical Center, GROW – Research Institute for Oncology and Reproduction, Maastricht, The NetherlandsDepartment of Pulmonary Diseases, GROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The Netherlands; Corresponding author. Address for correspondence: Lizza E. L. Hendriks, MD, PhD, Department of Pulmonary Diseases, GROW – Research Institute for Oncology and Reproduction, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.Introduction: The impact of an immune checkpoint inhibitor (ICI)–based systemic treatment strategy with or without local radical treatment (LRT) on outcomes for patients with NSCLC and synchronous oligometastatic disease (sOMD) is unknown. Methods: Multicenter retrospective study including adequately staged patients, with sOMD NSCLC (maximum five metastases in three organs [European Organization for Research and Treatment of Cancer definition]) between January 1, 2015 and December 31, 2022, treated with a first-line ICI-based versus chemotherapy-only regimen. Primary end points were progression-free survival and overall survival (OS) for an ICI-based versus chemotherapy-only strategy. Subgroup analyses were performed for patients who were deemed candidates for LRT in the multidisciplinary meeting and those proceeding to LRT. Results: A total of 416 patients were included, treated with chemotherapy-ICI (n = 138) or chemotherapy-only (n = 278), 319 out of 416 were deemed candidates by multidisciplinary meetings for LRT, whereas 192 (60%) proceeded to LRT. The median OS was significantly longer in the chemotherapy-ICI compared with the chemotherapy-only group (33.6 versus 15.9 mo, hazard ratio [HR] = 0.5, 95% confidence interval [CI]: 0.4–0.7, p < 0.001), in the subgroups who were candidate for LRT (36.1 versus 17.2 mo, HR = 0.5, 95% CI: 0.4–0.7, p < 0.001) and those proceeding to LRT (not reached versus 23.1 mo, HR = 0.4, 95% CI: 0.2–0.7, p < 0.001). In multivariate analysis, an ICI-based strategy was associated with improved survival in the total group (HR = 0.6, 95% CI: 0.4–0.9, p < 0.001), in those with intention of LRT (HR = 0.6, 95% CI: 0.4–0.9, p = 0.02) and those who proceeded to LRT (HR = 0.3, 95% CI: 0.1–0.6, p = 0.002). Conclusions: An ICI-based systemic treatment strategy (±LRT) is associated with improved survival compared with chemotherapy-only (±LRT) for patients with sOMD NSCLC. Prospective randomized trial data are necessary to identify patients most likely to benefit from adding LRT.http://www.sciencedirect.com/science/article/pii/S2666364325000062NSCLCSynchronous oligometastatic diseaseImmune checkpoint inhibitorsProgression free survivalOverall survival |
| spellingShingle | Mandy Jongbloed, MD Valentina Bartolomeo, MD Martina Bortolot, MD Shahan Darwesh, MD Jarno W.J. Huijs, MD Safiye Dursun, MD Juliette Degens, MD, PhD Ben E.E.M. van den Borne, MD, PhD Maggy Youssef-El Soud, MD, PhD Marcel Westenend, MD, PhD Cordula Pitz, MD, PhD Dirk K.M. De Ruysscher, MD, PhD Lizza E.L. Hendriks, MD, PhD Impact of Immune Checkpoint Inhibitors and Local Radical Treatment on Survival Outcomes in Synchronous Oligometastatic NSCLC JTO Clinical and Research Reports NSCLC Synchronous oligometastatic disease Immune checkpoint inhibitors Progression free survival Overall survival |
| title | Impact of Immune Checkpoint Inhibitors and Local Radical Treatment on Survival Outcomes in Synchronous Oligometastatic NSCLC |
| title_full | Impact of Immune Checkpoint Inhibitors and Local Radical Treatment on Survival Outcomes in Synchronous Oligometastatic NSCLC |
| title_fullStr | Impact of Immune Checkpoint Inhibitors and Local Radical Treatment on Survival Outcomes in Synchronous Oligometastatic NSCLC |
| title_full_unstemmed | Impact of Immune Checkpoint Inhibitors and Local Radical Treatment on Survival Outcomes in Synchronous Oligometastatic NSCLC |
| title_short | Impact of Immune Checkpoint Inhibitors and Local Radical Treatment on Survival Outcomes in Synchronous Oligometastatic NSCLC |
| title_sort | impact of immune checkpoint inhibitors and local radical treatment on survival outcomes in synchronous oligometastatic nsclc |
| topic | NSCLC Synchronous oligometastatic disease Immune checkpoint inhibitors Progression free survival Overall survival |
| url | http://www.sciencedirect.com/science/article/pii/S2666364325000062 |
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