Clinical Outcomes of Patients With Metastatic NSCLC After Discontinuation of Immunotherapy Because of Immune-Related Adverse Effects

Lysanne A Lievense; Peter Heukels; Nico C van Walree; Cor H van der Leest

doi:10.1016/j.jtocrr.2022.100441

Clinical Outcomes of Patients With Metastatic NSCLC After Discontinuation of Immunotherapy Because of Immune-Related Adverse Effects

JTO Clin Res Rep. 2022 Nov 25;4(1):100441. doi: 10.1016/j.jtocrr.2022.100441. eCollection 2023 Jan.

Authors

Lysanne A Lievense¹, Peter Heukels¹, Nico C van Walree¹, Cor H van der Leest¹

Affiliation

¹ Department of Pulmonary Medicine, Amphia Hospital, Breda, The Netherlands.

Abstract

Introduction: Immune checkpoint inhibition (ICI) is an important treatment modality in metastatic NSCLC and management of immunotherapy-related adverse effects (irAEs) can be challenging. Retreatment after discontinuation of ICI because of irAEs is a frequent clinical dilemma with limited available data.

Methods: This single-center retrospective observational study reviewed the clinical course of 30 patients with metastatic NSCLC in whom ICI had to be discontinued owing to a serious irAE after an initial objective response to therapy.

Results: After ICI discontinuation, 14 patients (47%) developed a durable response of more than 6 months, seven patients (23%) developed oligoprogression treated with local radiotherapy leading to disease control, six patients (20%) had progression of disease within 6 months, and three patients (10%) died owing to a severe irAE.

Conclusions: A watchful waiting approach is justified after discontinuation of ICI owing to irAEs in patients with metastatic NSCLC with an initial response to therapy.

Keywords: Clinical outcomes; Immune-related adverse effects; Immunotherapy; Non–small cell lung cancer.