Continued Immunotherapy Beyond Progression May Extend Survival in Metastatic NSCLC
A retrospective study of patients with metastatic non–small cell lung cancer (NSCLC) treated at Ohio State University has found that continuing immune checkpoint inhibitors (ICIs) beyond disease progression is associated with significantly improved survival outcomes. The findings, drawn from a cohort of 366 patients who received first-line ICI-based therapy between 2017 and 2022, underscore a potential benefit of extending immunotherapy beyond traditional progression thresholds in clinical practice.
The median progression-free survival (PFS) across the full cohort was 9.26 months, while the median overall survival (OS) reached 18.86 months. Disease control was notable, with 41.26% of patients achieving a partial response and 40.98% achieving stable disease. Upon disease progression—experienced by nearly 67% of patients—approximately 31% continued ICI therapy beyond progression.
Among these patients, median OS from the point of progression was 10.87 months, compared with just 4.33 months in those who did not continue ICIs post-progression (log-rank P = .0034). Multivariable analysis confirmed a significantly increased risk of progression (hazard ratio, 1.853; 95% CI, 1.353-2.538; P < .001) in patients who discontinued ICIs, even after adjusting for programmed cell death ligand 1 (PD-L1) expression, Eastern Cooperative Oncology Group (ECOG) performance status, and tumor histology.
“A substantial number of patients with metastatic NSCLC in our study received first-line ICI-based treatment beyond progression and achieved meaningful survival,” the authors noted. However, they caution that selection bias may influence which patients are eligible or suitable for continued treatment. Further investigation into the clinical and molecular characteristics of these patients—as well as the integration of post-progression therapies—will be essential for optimizing treatment sequencing.
Reference
Johns N, Rudich A, Zhao S, et al. CLO25-053: real-world evidence of survival in patients with metastatic NSCLC treated with first-line immune checkpoint ihibitors beyond progression. J Natl Compr Canc Netw. 2025;23(3.5):CLO25-053. doi:10.6004/jnccn.2024.7160
