Clinical pattern of failure after a durable response to immune check inhibitors in non-small cell lung cancer patients

Abstract Although immune checkpoint inhibitors (ICIs) can induce durable responses in non-small-cell lung cancer (NSCLC) patients, a significant proportion of responders still experience progressive disease after a period of response. Limited data are available on the clinical patterns of acquired r...

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Autores principales:	Ja Yoon Heo, Shin Hye Yoo, Koung Jin Suh, Se Hyun Kim, Yu Jung Kim, Chan-Young Ock, Miso Kim, Bhumsuk Keam, Tae Min Kim, Dong-Wan Kim, Dae Seog Heo, Jong Seok Lee
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6baa071334004d26bec6ff48566948c7
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spelling	oai:doaj.org-article:6baa071334004d26bec6ff48566948c72021-12-02T13:24:37ZClinical pattern of failure after a durable response to immune check inhibitors in non-small cell lung cancer patients10.1038/s41598-021-81666-x2045-2322https://doaj.org/article/6baa071334004d26bec6ff48566948c72021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81666-xhttps://doaj.org/toc/2045-2322Abstract Although immune checkpoint inhibitors (ICIs) can induce durable responses in non-small-cell lung cancer (NSCLC) patients, a significant proportion of responders still experience progressive disease after a period of response. Limited data are available on the clinical patterns of acquired resistance (AR) to ICIs. Clinical and radiologic data from 125 NSCLC patients treated with anti-PD-1 or PD-L1 antibodies between 2011 and 2018 at two tertiary academic institutions were retrospectively reviewed. Overall, 63 (50.4%) patients experienced AR after ICI treatment in a median of 10.7 months. Among the 13 patients with a partial response with ICI, 12 (32.4%) had only lymph node progression. Most patients (n = 52, 82.5%) had one or two sites with progression (oligo-progression). The median overall survival (OS) after progression was significantly longer in the extrathoracic group than in the thoracic and liver progression groups (30.2 months [95% confidence interval (CI), 13.4 to not reached (NR)], 11.7 months [95% CI, 9.5–21.1], and 5.4 months [95% CI, 2.6-NR], respectively, P < 0.001). Patients with oligo-progression had significantly longer OS after AR than did the multi-progression patients (18.9 months [95% CI, 10.6-NR] vs. 8.8 months [95% CI, 5.7-NR], P = 0.04). No significant difference in progression-free survival was observed between the subsequent chemotherapy and the ICI after AR groups (P = 0.723). Patients with AR after ICI treatment had a unique progression pattern with oligo-progression and high rates of progression only in the lymph nodes. Local treatment and/or continuation of ICIs beyond AR might be an effective option.Ja Yoon HeoShin Hye YooKoung Jin SuhSe Hyun KimYu Jung KimChan-Young OckMiso KimBhumsuk KeamTae Min KimDong-Wan KimDae Seog HeoJong Seok LeeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ja Yoon Heo Shin Hye Yoo Koung Jin Suh Se Hyun Kim Yu Jung Kim Chan-Young Ock Miso Kim Bhumsuk Keam Tae Min Kim Dong-Wan Kim Dae Seog Heo Jong Seok Lee Clinical pattern of failure after a durable response to immune check inhibitors in non-small cell lung cancer patients
description	Abstract Although immune checkpoint inhibitors (ICIs) can induce durable responses in non-small-cell lung cancer (NSCLC) patients, a significant proportion of responders still experience progressive disease after a period of response. Limited data are available on the clinical patterns of acquired resistance (AR) to ICIs. Clinical and radiologic data from 125 NSCLC patients treated with anti-PD-1 or PD-L1 antibodies between 2011 and 2018 at two tertiary academic institutions were retrospectively reviewed. Overall, 63 (50.4%) patients experienced AR after ICI treatment in a median of 10.7 months. Among the 13 patients with a partial response with ICI, 12 (32.4%) had only lymph node progression. Most patients (n = 52, 82.5%) had one or two sites with progression (oligo-progression). The median overall survival (OS) after progression was significantly longer in the extrathoracic group than in the thoracic and liver progression groups (30.2 months [95% confidence interval (CI), 13.4 to not reached (NR)], 11.7 months [95% CI, 9.5–21.1], and 5.4 months [95% CI, 2.6-NR], respectively, P < 0.001). Patients with oligo-progression had significantly longer OS after AR than did the multi-progression patients (18.9 months [95% CI, 10.6-NR] vs. 8.8 months [95% CI, 5.7-NR], P = 0.04). No significant difference in progression-free survival was observed between the subsequent chemotherapy and the ICI after AR groups (P = 0.723). Patients with AR after ICI treatment had a unique progression pattern with oligo-progression and high rates of progression only in the lymph nodes. Local treatment and/or continuation of ICIs beyond AR might be an effective option.
format	article
author	Ja Yoon Heo Shin Hye Yoo Koung Jin Suh Se Hyun Kim Yu Jung Kim Chan-Young Ock Miso Kim Bhumsuk Keam Tae Min Kim Dong-Wan Kim Dae Seog Heo Jong Seok Lee
author_facet	Ja Yoon Heo Shin Hye Yoo Koung Jin Suh Se Hyun Kim Yu Jung Kim Chan-Young Ock Miso Kim Bhumsuk Keam Tae Min Kim Dong-Wan Kim Dae Seog Heo Jong Seok Lee
author_sort	Ja Yoon Heo
title	Clinical pattern of failure after a durable response to immune check inhibitors in non-small cell lung cancer patients
title_short	Clinical pattern of failure after a durable response to immune check inhibitors in non-small cell lung cancer patients
title_full	Clinical pattern of failure after a durable response to immune check inhibitors in non-small cell lung cancer patients
title_fullStr	Clinical pattern of failure after a durable response to immune check inhibitors in non-small cell lung cancer patients
title_full_unstemmed	Clinical pattern of failure after a durable response to immune check inhibitors in non-small cell lung cancer patients
title_sort	clinical pattern of failure after a durable response to immune check inhibitors in non-small cell lung cancer patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/6baa071334004d26bec6ff48566948c7
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Clinical pattern of failure after a durable response to immune check inhibitors in non-small cell lung cancer patients

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