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Purpose <p>Appropriate local therapy may provide survival benefits in oligometastatic non-small cell lung cancer (NSCLC) patients receiving chemotherapy or targeted therapy. However, its roles in immunotherapy-treated patients have not been fully understood.</p> Methods <p>PD-1/PD-L1 inhibitor-treated metastatic NSCLC patients were enrolled in a prospective multi-center observational study (NCT04766515) from September 2020 to March 2023. Those without driver mutations, with measurable disease and harboring oligometastatic disease were included. Progression-free survival (PFS) and overall survival (OS) were compared between those with or without early local therapy (eLT). Moreover, eLT performed within or after 1&#xa0;month of the initiation of PD-1/PD-L1 inhibitors was defined as concurrent- or sequential-LT, respectively. While, eLT targeting partial or all of the tumor lesions, was described as partial- or all-LT, respectively.</p> Results <p>Among the 180 patients identified, eLT was performed in 44, including concurrent-LT in 25 and all-LT in 19, respectively. With a median follow-up of 19.40&#xa0;months, progressive disease occurred in 95 of the 136 patients without eLT. Compared to those without eLT, patients receiving eLT had significantly longer PFS (HR = 0.40, 95% CI 0.27–0.59, <i>p</i> &lt; 0.0001) and OS (HR = 0.43, 95% CI 0.24–0.76, <i>p</i> = 0.02). Moreover, eLT was associated with improved survival after Cox analyses and propensity score matching. Meanwhile, sequential-LT, as well as all-LT, was associated with longer OS, when compared with concurrent-LT or partial-LT, respectively.</p> Conclusions <p>Early local therapy, especially those performed after effective systemic therapy and targeting all tumor lesions, may prolong patient’s survival in PD-1/PD-L1 inhibitor-treated oligometastatic NSCLC.</p>

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Early local therapy in combination with PD-1/PD-L1 inhibitors in oligometastatic non-small cell lung cancer: results from a prospective multicenter observational study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月19日

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  • Jie Gao,
  • Aihua Lan,
  • Xi Yang,
  • Li Chu,
  • Xiao Chu,
  • Yue Zhou,
  • Hongru Chen,
  • Silai Yu,
  • Yechun Pang,
  • Jie Hu,
  • Qian Chu,
  • Jianjiao Ni,
  • Zhengfei Zhu

摘要

Purpose

Appropriate local therapy may provide survival benefits in oligometastatic non-small cell lung cancer (NSCLC) patients receiving chemotherapy or targeted therapy. However, its roles in immunotherapy-treated patients have not been fully understood.

Methods

PD-1/PD-L1 inhibitor-treated metastatic NSCLC patients were enrolled in a prospective multi-center observational study (NCT04766515) from September 2020 to March 2023. Those without driver mutations, with measurable disease and harboring oligometastatic disease were included. Progression-free survival (PFS) and overall survival (OS) were compared between those with or without early local therapy (eLT). Moreover, eLT performed within or after 1 month of the initiation of PD-1/PD-L1 inhibitors was defined as concurrent- or sequential-LT, respectively. While, eLT targeting partial or all of the tumor lesions, was described as partial- or all-LT, respectively.

Results

Among the 180 patients identified, eLT was performed in 44, including concurrent-LT in 25 and all-LT in 19, respectively. With a median follow-up of 19.40 months, progressive disease occurred in 95 of the 136 patients without eLT. Compared to those without eLT, patients receiving eLT had significantly longer PFS (HR = 0.40, 95% CI 0.27–0.59, p < 0.0001) and OS (HR = 0.43, 95% CI 0.24–0.76, p = 0.02). Moreover, eLT was associated with improved survival after Cox analyses and propensity score matching. Meanwhile, sequential-LT, as well as all-LT, was associated with longer OS, when compared with concurrent-LT or partial-LT, respectively.

Conclusions

Early local therapy, especially those performed after effective systemic therapy and targeting all tumor lesions, may prolong patient’s survival in PD-1/PD-L1 inhibitor-treated oligometastatic NSCLC.