Long-term outcomes in patients with Non Small Cell Lung Cancer (NSCLC) treated by Immune Checkpoint Inhibitors (ICIs) for a minimal duration of 2 years: a cohort study in a tertiary hospital.

Abstract

<b>Introduction:</b> ICIs are a cornerstone in advanced NSCLC. ICIs are interrupted after two years in most trials in case of long lasting oncologic response. However, concerns about the proper schedule for&nbsp;discontinuing ICIs have been raised by many clinicians. <b>Objectives:</b> we aim to describe the long-term clinical outcomes in metastatic NSCLC patients treated by ICIs for a minimal duration of 2 years. <b>Methods:</b> This is a retrospective chart review in the three units of thoracic oncology of Lyon University Hospital. We selected all patients with NSCLC who completed at least 2 years of treatment by pembrolizumab or nivolumab. ICIs should have been started from January 2015 to April 2019 and&nbsp;the minimal follow-up duration was set at&nbsp;30 months after the initiation of ICIs. <b>Results:</b> 61 patients were enrolled. 72% were male, with a median age of 64 years. ICIs were discontinued for 54% of patients after a median duration of 27.8 months (+/−SD) for pembrolizumab and 29.2 months (+/−SD) for nivolumab, because of a controlled disease according to RECIST criteria. 82% of these patients remained under control until data cutoff and 18% experienced disease progression after a median duration of 10 months after ICIs discontinuation. 3 patients were successfully rechallenged with ICIs after disease progression and all experimented an objective response. Among those who did not stop ICIs, 78% remained with a controlled disease. <b>Conclusion:</b> Our study suggests the discontinuation of ICIs is feasible for responders while still obtaining good results. Progressive disease&nbsp;could be rechallenged.