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Abstract：
BACKGROUND: No definite conclusion has yet to be reached for immunotherapy beyond progression(IBP) of first-line immunotherapy as the second-line treatment for advanced NSCLC patients with negative driver genes. Therefore a retrospective study was conducted to evaluate the efficacy of IBP in this population and investigated whether the cycles best response and progressive mode of first-line immunotherapy could affect the results.
METHODS: The clinical data of patients with advanced NSCLC whose response was evaluated as progressive disease (PD) after receiving a PD-1/PD-L1 inhibitors as first-line therapy were retrospectively collected and the patients were assigned to the IBP and non-IBP groups. The overall survival (OS), progression-free survival (PFS) were evaluated between the two groups. The survival effects of cycles best response and progressive mode of first-line immunotherapy were also evaluated.
RESULTS: Between January 2019 and January 2022, a total of 121 patients was evaluated as PD after first-line immunotherapy in our institution; 53 (43.8%) patients were included in the IBP group and 68 (56.2%) patients were included in the non-IBP group. The OS and PFS were no significantly different between the two groups in whole population. Further analysis revealed the OS was prolonged with the prolongation of first-line medication cycle. The median OS was 15.4m (15.4 vs 10.8 p=0.047) 16.1m (16.1 vs 10.8 p=0.039), 16.3m (16.3 vs 10.9 p=0.029) for patients with ≥4, ≥6, ≥8 cycles in first-line immunotherapy, respectively. The advantages of OS and PFS were also seen in the subgroup of PR (best response) and oligo progression of first-line immunotherapy.
CONCLUSIONS: The clinical outcomes of IBP were similar to those of non-IBP in patients with PD after first-line immnuotherapy in advanced NSCLC. But more cycles, PR as best response and oligo progression in first-line was benefit.
METHODS: The clinical data of patients with advanced NSCLC whose response was evaluated as progressive disease (PD) after receiving a PD-1/PD-L1 inhibitors as first-line therapy were retrospectively collected and the patients were assigned to the IBP and non-IBP groups. The overall survival (OS), progression-free survival (PFS) were evaluated between the two groups. The survival effects of cycles best response and progressive mode of first-line immunotherapy were also evaluated.
RESULTS: Between January 2019 and January 2022, a total of 121 patients was evaluated as PD after first-line immunotherapy in our institution; 53 (43.8%) patients were included in the IBP group and 68 (56.2%) patients were included in the non-IBP group. The OS and PFS were no significantly different between the two groups in whole population. Further analysis revealed the OS was prolonged with the prolongation of first-line medication cycle. The median OS was 15.4m (15.4 vs 10.8 p=0.047) 16.1m (16.1 vs 10.8 p=0.039), 16.3m (16.3 vs 10.9 p=0.029) for patients with ≥4, ≥6, ≥8 cycles in first-line immunotherapy, respectively. The advantages of OS and PFS were also seen in the subgroup of PR (best response) and oligo progression of first-line immunotherapy.
CONCLUSIONS: The clinical outcomes of IBP were similar to those of non-IBP in patients with PD after first-line immnuotherapy in advanced NSCLC. But more cycles, PR as best response and oligo progression in first-line was benefit.
摘要：
背景：对于一线免疫疗法（IBP）作为具有阴性驱动基因的晚期NSCLC患者的二线治疗，尚未达成明确的结论。因此，进行了一项回顾性研究以评估IBP在该人群中的疗效，并研究了一线免疫治疗的最佳反应和渐进模式是否会影响结果。
方法：回顾性收集接受PD-1/PD-L1抑制剂作为一线治疗后评估为进行性疾病（PD）的晚期NSCLC患者的临床资料，并将患者分为IBP和非IBP组。总生存期（OS），评估两组间的无进展生存期(PFS).还评估了周期最佳反应和一线免疫治疗的渐进模式的生存效果。
结果：在2019年1月至2022年1月期间，共有121例患者在我们机构进行了一线免疫治疗后被评估为PD；53例（43.8％）患者被纳入IBP组，68例（56.2％）患者被纳入非IBP组。在整个人群中，两组之间的OS和PFS没有显着差异。进一步分析显示，随着一线用药周期的延长，OS延长。中位OS为15.4m（15.4vs10.8p=0.047）16.1m（16.1vs10.8p=0.039），在一线免疫治疗中，≥4，≥6，≥8个周期的患者为16.3m（16.3vs10.9p=0.029），分别。OS和PFS的优势也在PR（最佳反应）和一线免疫疗法的寡核苷酸进展亚组中看到。
结论：在晚期非小细胞肺癌患者行一线治疗后，IBP与非IBP的临床结果相似。但是更多的周期，PR作为最佳反应，一线寡聚体进展是有益的。
方法：回顾性收集接受PD-1/PD-L1抑制剂作为一线治疗后评估为进行性疾病（PD）的晚期NSCLC患者的临床资料，并将患者分为IBP和非IBP组。总生存期（OS），评估两组间的无进展生存期(PFS).还评估了周期最佳反应和一线免疫治疗的渐进模式的生存效果。
结果：在2019年1月至2022年1月期间，共有121例患者在我们机构进行了一线免疫治疗后被评估为PD；53例（43.8％）患者被纳入IBP组，68例（56.2％）患者被纳入非IBP组。在整个人群中，两组之间的OS和PFS没有显着差异。进一步分析显示，随着一线用药周期的延长，OS延长。中位OS为15.4m（15.4vs10.8p=0.047）16.1m（16.1vs10.8p=0.039），在一线免疫治疗中，≥4，≥6，≥8个周期的患者为16.3m（16.3vs10.9p=0.029），分别。OS和PFS的优势也在PR（最佳反应）和一线免疫疗法的寡核苷酸进展亚组中看到。
结论：在晚期非小细胞肺癌患者行一线治疗后，IBP与非IBP的临床结果相似。但是更多的周期，PR作为最佳反应，一线寡聚体进展是有益的。
