Immunotherapy beyond progression combined with platinum-based chemotherapy after primary resistance to first-line immunotherapy in patients with advanced NSCLC and PD-L1 ≥50%

作者：Andrea De Giglio, L Zullo, Alessandro Di Federico, Massimiliano Cani, Mihaela Aldea, Davide Soldato, Filippo Gustavo Dall’Olio, Francesco Mantuano, Francesca Sperandi, Valentina Favorito, A. Sadowska, Lizza Hendriks, T. Gorria, Laura Mezquita, Fabrizio Tabbò, Silvia Novello, Francesco Gelsomino, B. Besse, Andrea Ardizzoni · 发表于：ESMO Open · 年份：2025 · DOI：10.1016/j.esmoop.2025.105897 · 被引用次数：4 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Diagnosis and Treatment、Colorectal and Anal Carcinomas

BACKGROUND: Primary resistance to immune checkpoint inhibitors (ICIs) remains a major challenge in patients with advanced non-small-cell lung cancer (NSCLC) and programmed death-ligand 1 (PD-L1) expression ≥50%. The benefit of continuing ICIs beyond progression in combination with chemotherapy is unclear. PATIENTS AND METHODS: This multicenter retrospective study included patients with advanced NSCLC and PD-L1 ≥50% treated with first-line ICI monotherapy at five European centers. Primary resistance was defined as progressive disease as best response or stable disease lasting <6 months. Outcomes of second-line platinum-based chemotherapy alone or combined with ICI were compared. The primary endpoint was progression-free survival 2, defined as time from first-line ICI initiation to second-line progression or death. RESULTS: Among 293 eligible patients, 119 (38%) showed primary resistance. Compared with those who did not develop primary resistance, patients with primary resistance more often had multisite progression (74% versus 42%) and less often oligoprogression (13% versus 54%) (P < 0.001). Second-line platinum-based chemotherapy was administered to 43.7% (52/119) of patients with primary resistance, 34.6% (18/52) of whom received ICI beyond progression. Baseline characteristics were comparable across treatment groups. Patients who received ICI beyond progression, compared with those who received only chemotherapy, had significantly longer median progression-free survival 2 ...