ASCO: Lack of Benefit Seen for Indefinite-Duration Immunotherapy in NSCLC

Lack of significant overall survival advantage seen for indefinite-duration versus fixed-duration immunotherapy

For patients with advanced non-small cell lung cancer (NSCLC), indefinite duration of immunotherapy treatment does not seem to offer benefits over fixed-duration therapy for two years, according to a study published online June 4 in JAMA Oncology to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

Lova Sun, M.D., from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective, population-based cohort study involving adults diagnosed with advanced NSCLC from 2016 to 2020 who received frontline immunotherapy-based treatment. Practice patterns surrounding treatment discontinuation at two years (between 700 and 760 days; fixed duration) versus continued treatment beyond two years (greater than 760 days; indefinite duration) were compared. Of 1,091 patients who were still on immune checkpoint inhibitor (ICI) treatment at two years, 113 and 593 were in the fixed-duration and indefinite-duration groups, respectively.

The researchers found that the two-year overall survival from 760 days was 79 and 81 percent in the fixed-duration and indefinite-duration groups, respectively. No significant difference was seen in overall survival for patients in the fixed-duration or indefinite-duration groups in a univariate or multivariable analysis. In the absence of progression, about one in five patients discontinued treatment at two years.

“These findings provide reassurance that for patients with advanced NSCLC whose disease is still responding to ICI therapy at two years, stopping therapy and monitoring rather than continuing immunotherapy indefinitely is a reasonable strategy with sustained clinical benefit,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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