Abstract
BackgroundImmune checkpoint inhibitors (ICIs) have emerged as promising therapeutic agents in non-small cell lung cancer (NSCLC). However, the duration for which ICIs should be continued remains a clinical problem.MethodsWe examined the efficacy of anti-PD-1/PD-L1 inhibitors after the discontinuation of antibodies due to adverse events (AEs) in patients with NSCLC. This was a multicenter retrospective study that analyzed NSCLC patients who were treated with PD-1/PD-L1 inhibitors by August 2016.ResultsThe patients with NSCLC were 18 males and 1 female at a median 67 years of age (range: 49–80 years). Eighteen of 19 patients were treated with nivolumab, one was with atezolizumab. Approximately half of AEs were interstitial pneumonia. Fourteen patients (73.7%) were treated with steroid therapy. The median number of treatment cycles was 7 (range, 1–70), and the median duration of treatment was 2.8 months (range, 1 day-32.9 months). The overall response rate with confirmation during treatment was 21.1%. The median progression-free survival (PFS) was 10.2 months (95% confidence interval [CI] = 3.2–17.1 months) and 5.6 months (95% CI = 0–12.2 months) from the initiation and the discontinuation of PD-1/PD-L1 treatment, respectively. The median PFS after discontinuation according to the confirmed response during administration was not reached for partial response (PR) and 4.9 months (95% CI, 3.7–6.0) for stable disease (SD) patients (P = 0.02).ConclusionThe PFS of the PR patients was completely different from that of the SD patients. The cases with PR prior to the onset of AE tended to show a durable response after the discontinuation of PD-1/PD-L1 inhibitors.
Highlights
Immune checkpoint inhibitors (ICIs) have emerged as promising therapeutic agents in non-small cell lung cancer (NSCLC)
We retrospectively evaluated the efficacy of PD-1/PD-L1 inhibitors after the discontinuation of these antibodies due to adverse events (AEs) in patients with NSCLC at Japanese cancer research institutes
Patients characteristics Of the 192 patients who underwent anti-PD-1/PD-L1 treatment, we analyzed 19 patients (18 men and 1 woman) in whom treatment was stopped due to immune-related adverse events (irAEs)
Summary
Immune checkpoint inhibitors (ICIs) have emerged as promising therapeutic agents in non-small cell lung cancer (NSCLC). Recent progress in the treatment of advanced nonsmall cell lung cancer (NSCLC) has been remarkable and promising. The PD-1 receptor is an immune checkpoint inhibitor expressed on activated T cells that downregulates excessive immune responses [1, 2]. Treatment with anti-PD-1/PD-L1 antibodies is associated with toxicities known as immune-related adverse events (irAEs) [6,7,8,9,10,11,12,13,14,15,16,17]. Tachihara et al BMC Cancer (2018) 18:946 months, but the frequency of AEs increase with continued therapy [8, 13]. It is important to determine the appropriate period of administration of anti-PD-1/ PD-L1 antibodies
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