Abstract：
BACKGROUND: The prognosis of metastatic non-small cell lung cancer (NSCLC) has been improved by the use of immune checkpoint inhibitors (ICI). Unfortunately, in some cases, cancer cells will develop resistance mechanisms. In case of progression in a limited number of lesions (oligoprogression), focal treatment with radiotherapy is proposed while continuing the ICI therapy.
METHODS: A cohort of 37 patients with metastatic NSCLC treated with nivolumab (anti-PD-1) in second or subsequent line and who received focal radiotherapy for oligoprogression with continuation of nivolumab was compared with a control cohort of 87 patients no oligoprogressor treated par immunotherapy.
RESULTS: After a median follow-up of 37 months [18; 62], the median progression free survival (PFS) in the radiotherapy-treated cohort was 15.04 versus 5.04 months in the control cohort, with a statistically significant difference (P=0.048). The median PFS following focal radiotherapy in the oligoprogressor group was 7.5 months. In univariate analysis, the presence of lung metastasis was associated with increased PFS, in contrast to the presence of brain metastases, which were associated with decreased PFS in the radiotherapy group. The median overall survival was not reached in both groups, with no significant difference between the two cohorts.
CONCLUSIONS: The combination of focal radiotherapy in case of oligoprogression and continued treatment with nivolumab in the treatment of metastatic NSCLC in the second or subsequent line of treatment seems to be with an increase in PFS.
METHODS: A cohort of 37 patients with metastatic NSCLC treated with nivolumab (anti-PD-1) in second or subsequent line and who received focal radiotherapy for oligoprogression with continuation of nivolumab was compared with a control cohort of 87 patients no oligoprogressor treated par immunotherapy.
RESULTS: After a median follow-up of 37 months [18; 62], the median progression free survival (PFS) in the radiotherapy-treated cohort was 15.04 versus 5.04 months in the control cohort, with a statistically significant difference (P=0.048). The median PFS following focal radiotherapy in the oligoprogressor group was 7.5 months. In univariate analysis, the presence of lung metastasis was associated with increased PFS, in contrast to the presence of brain metastases, which were associated with decreased PFS in the radiotherapy group. The median overall survival was not reached in both groups, with no significant difference between the two cohorts.
CONCLUSIONS: The combination of focal radiotherapy in case of oligoprogression and continued treatment with nivolumab in the treatment of metastatic NSCLC in the second or subsequent line of treatment seems to be with an increase in PFS.
摘要：
背景：使用免疫检查点抑制剂（ICI）改善了转移性非小细胞肺癌（NSCLC）的预后。不幸的是,在某些情况下,癌细胞会产生抗性机制。在有限数量的病变进展的情况下（少进展），建议在继续ICI治疗的同时进行放疗的局部治疗.
方法：将37例转移性NSCLC患者在第二行或后续行接受纳武单抗（抗PD-1）治疗，并接受局灶性放疗以少进展继续使用纳武单抗治疗的对照组与87例患者的对照组进行比较。
结果：经过37个月的中位随访[18;62]，放疗组的中位无进展生存期(PFS)为15.04个月,对照组为5.04个月,差异有统计学意义(P=0.048)。在弱进展组中，局灶性放疗后的中位PFS为7.5个月。在单变量分析中，肺转移的存在与PFS增加有关，与脑转移的存在相反，与放疗组PFS降低相关。两组均未达到中位总生存期，两个队列之间没有显着差异。
结论：在次要或后续治疗中，在治疗转移性NSCLC时，联合使用局灶性放疗和继续使用纳武单抗治疗相结合，似乎增加了PFS。
方法：将37例转移性NSCLC患者在第二行或后续行接受纳武单抗（抗PD-1）治疗，并接受局灶性放疗以少进展继续使用纳武单抗治疗的对照组与87例患者的对照组进行比较。
结果：经过37个月的中位随访[18;62]，放疗组的中位无进展生存期(PFS)为15.04个月,对照组为5.04个月,差异有统计学意义(P=0.048)。在弱进展组中，局灶性放疗后的中位PFS为7.5个月。在单变量分析中，肺转移的存在与PFS增加有关，与脑转移的存在相反，与放疗组PFS降低相关。两组均未达到中位总生存期，两个队列之间没有显着差异。
结论：在次要或后续治疗中，在治疗转移性NSCLC时，联合使用局灶性放疗和继续使用纳武单抗治疗相结合，似乎增加了PFS。
