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2024 ESMO China · What is the prognosis of survival with immunotherapy and re-challenge? Take a look at the model prediction of the nomogram

2024 ESMO China · What is the prognosis of survival with immunotherapy and re-challenge? Take a look at the model prediction of the nomogram

preface

In the vast stars of medicine, every academic collision may bring new sparks and inspiration. The 2024 Annual Meeting of the European Society for Medical Oncology (ESMO) was held in Barcelona, Spain, from September 13 to 17. This is an academic feast that gathers global wisdom, and a high-quality stage for medical researchers to share the latest research results, discuss cutting-edge diagnosis and treatment strategies, and exchange experiences.

In this year's ESMO poster session, based on a retrospective analysis of the efficacy and safety of real-world patients receiving immune checkpoint inhibitor rechallenge therapy for advanced lung cancer, the research team constructed a nomogram model to predict the survival of patients. The research content is compiled as follows for the benefit of readers.

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Background:

This study investigated the efficacy and safety of cross-line immunotherapy in patients with advanced primary lung cancer, and constructed and validated a prognostic nomogram model.

Research Methods:

The study performed a retrospective analysis of patients with advanced lung cancer who underwent immunotherapy rechallenge at nine cancer centers in China between June 2018 and June 2023. The Kaplan-Meier method was used for survival analysis, and the Cox proportional hazards model was used for univariate and multivariate regression analysis of prognosis. A nomogram model was constructed to predict the overall survival (OS) of patients who received immunotherapy and then challenged patients.

Findings:

A total of 263 eligible patients with lung cancer were included in the study. At a median follow-up of 29.2 months, patients had a median progression-free survival (PFS) of 3.7 months (95% CI: 3.0-4.4), a median OS of 21.1 months (95% CI: 18.5-23.7), an objective response rate (ORR) of 14.1%, and a disease control rate (DCR) of 68.5%.

2024 ESMO China · What is the prognosis of survival with immunotherapy and re-challenge? Take a look at the model prediction of the nomogram

In primary immunotherapy, PFS was significantly better in patients with PFS ≥ 6 months than in patients with PFS < 6 months (4.7 vs. 3.4, HR=0.738, 95% CI: 0.574–0.948, P=0.017). In addition, patients with a complete response (CR) or partial response (PR) had significantly longer OS than patients with stable disease (SD) or disease progression (PD) who had a best response to primary immunotherapy (25.1 vs. 19.1 months, HR=0.663, 95% CI: 0.480–0.916, P=0.013). Further analysis showed that the initial clinical stage of IIIB/C, the number of metastatic lesions <2, the number of lines of primary immunotherapy ≤2, the optimal response to primary immunotherapy was CR/PR, and the interruption of treatment due to immune-related toxicity may be potential factors for the benefit of patients when re-receiving immunotherapy. The nomogram model established by the research team can predict the survival of patients with high accuracy and has high clinical application value.

2024 ESMO China · What is the prognosis of survival with immunotherapy and re-challenge? Take a look at the model prediction of the nomogram

Conclusions of the study

This study demonstrates that the application of immunotherapy rechallenge after tumor recurrence is a safe and feasible treatment strategy, especially for patients with low tumor burden, long PFS of primary immunotherapy, and significant tumor shrinkage. The research team constructed and validated a nomogram model that provides a reference for predicting patient survival and guiding treatment decisions.

Bibliography:

Zhou Jin, et al. Efficacy and safety of immune checkpoint inhibitor rechallenge in advanced lung cancer: A multicenter, real-world study. 2024 ESMO. Abstract 1347P.

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