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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1525236
This article is part of the Research Topic Big Data and Precision Medicine: Diagnosis and Treatment, Drug Discovery, and Integration of Multiple Omics View all 5 articles

The clinical value of local consolidative therapy for oligo-residual disease in PD-1/PD-L1 inhibitors-treated non-small cell lung cancer

Provisionally accepted
Yuqi Su Yuqi Su 1Pan Luo Pan Luo 1*Ling Ni Ling Ni 1*Jianbin Hu Jianbin Hu 1*Jie Weng Jie Weng 1*Erdong Shen Erdong Shen 1*Qiang Zhou Qiang Zhou 1*Tao Chen Tao Chen 2*Jiwen Xiao Jiwen Xiao 3*Jia Xiao Jia Xiao 1*Wangti Xie Wangti Xie 1*Rong Shan Rong Shan 1*Xiang Yao Xiang Yao 1*Fang Wen Fang Wen 1*
  • 1 Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
  • 2 Department of Thoracic Surgery, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
  • 3 Department of Oncology, Hunan University of Medicine General Hosipital, Huaihua, Hunan,China, Huaihua, China

The final, formatted version of the article will be published soon.

    Background: Few real-world studies exist regarding the clinical value of local consolidative therapy (LCT) for oligo-residual disease (ORD) in NSCLC patients treated with immune checkpoint inhibitors. Therefore, we retrospectively evaluated whether LCT could improve the prognosis of NSCL patients with ORD after effective first-line PD-1/PD-L1 inhibitors treatment.Methods: A total of 132 patients with metastatic NSCLC who had received first-line PD-1/PD-L1inhibitors-based systemic treatment and developed ORD (defined as residual tumours limited to three organs and five lesions) were included. The LCT group consisted of 41 patients received LCTs for oligo-residual lesions before treatment failure, and the remaining 91 patients, who did not receive local therapies, constituted the non-LCT group. The progression-free survival (PFS) and overall survival (OS) of the two groups were analysed.Results: With a median follow-up of 12.0 months, 86 patients developed progressive disease and 42 patients died. Compared with the non-LCT group, LCT group exhibited significant longer progression-free survival (PFS) (median 11.0 vs. 7.0 months, P=0.017) and overall survival (OS) (median 26.0 vs. 17.0 months, P=0.003).Multivariable analysis demonstrated that LCT was an independent predictor of prolonged PFS (HR=0.606, 95% CI=0.370-0.964, P=0.035) and OS (HR=0.467, 95% CI=0.229-0.949, P=0.035). Subgroup analysis revealed that the dominant population considerably benefited from LCT in terms of PFS and OS included patients with 1-2 residual tumour sites (mPFS: 11.0 vs. 7.0 months, P=0.013; mOS: 23.0 vs. 17.0 months, P=0.018) and those with high PD-L1 expression (mPFS: 13.0 vs. 7.0 months, P=0.018; mOS: 34.0 vs. 16.0 months, P=0.030). In addition, the All-LCT group had significantly longer PFS (mPFS 16.0 vs. 7.0, P=0.002) and OS (mOS 28.0 vs. 17.0, P= 0.002) than did the non-LCT group. However, patients who received LCT to only some of their lesions had not experienced improvements in PFS (P=0.546) or OS (P=0.198).LCT may provide extra survival benefits among patients with oligo-residual NSCLC after effective first-line PD-1/PD-L1 inhibitors treatment, particularly in those patients with one or two residual lesions, high PD-L1 expression, or who had received LCT for all lesions. LCT may be a novel treatment option for this specific population.

    Keywords: Non-small cell lung cancer, Local consolidative therapy, PD-1/PD-L1 inhibitors, Oligo-residual disease, immune checkpoint inhibitors

    Received: 09 Nov 2024; Accepted: 03 Dec 2024.

    Copyright: © 2024 Su, Luo, Ni, Hu, Weng, Shen, Zhou, Chen, Xiao, Xiao, Xie, Shan, Yao and Wen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Pan Luo, Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
    Ling Ni, Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
    Jianbin Hu, Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
    Jie Weng, Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
    Erdong Shen, Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
    Qiang Zhou, Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
    Tao Chen, Department of Thoracic Surgery, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
    Jiwen Xiao, Department of Oncology, Hunan University of Medicine General Hosipital, Huaihua, Hunan,China, Huaihua, China
    Jia Xiao, Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
    Wangti Xie, Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
    Rong Shan, Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
    Xiang Yao, Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China
    Fang Wen, Department of Oncology, Yueyang Central Hospital, Yueyang, Hunan,China, Yueyang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.