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The benefit of treatment beyond progression with immune checkpoint inhibitors: a multi-center retrospective cohort study
Objective Treatment beyond progression (TBP) with immune checkpoint inhibitors (ICIs) is an evolving field due to the limitations of conventional imaging in response evaluation. However, real-life data on the benefit of TBP is scarce, especially from the limited resource settings and patients treate...
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| Published in: | Journal of cancer research and clinical oncology 2023-07, Vol.149 (7), p.3599-3606 |
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| container_title | Journal of cancer research and clinical oncology |
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| creator | Guven, Deniz Can Yekeduz, Emre Erul, Enes Yazgan, Sati Coskun Sahin, Taha Koray Karatas, Gokturk Aksoy, Sercan Erman, Mustafa Yalcin, Suayib Urun, Yuksel Kilickap, Saadettin |
| description | Objective
Treatment beyond progression (TBP) with immune checkpoint inhibitors (ICIs) is an evolving field due to the limitations of conventional imaging in response evaluation. However, real-life data on the benefit of TBP is scarce, especially from the limited resource settings and patients treated in the later lines. Therefore, we aimed to investigate the survival benefit of TBP with ICIs in patients with advanced tumors from a limited resource setting.
Methods
For this multi-center retrospective cohort study, we included 282 patients treated with ICIs and had radiological progression according to RECIST 1.1 criteria. We evaluated post-progression survival according to the use of TBP (TBP and non-TBP groups) with univariate and multivariate analyses.
Results
The cohort’s median age was 61, and 84.4% were treated in the second or later lines. 82 (29.1%) of 282 patients continued on ICIs following the initial progression. In multivariate analyses, patients in the TBP group had improved post-progression survival compared to non-TBP (13.18 vs. 4.63 months, HR: 0.500, 95% CI: 0.349–0.717,
p
|
| doi_str_mv | 10.1007/s00432-022-04268-8 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2702182725</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2831889004</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-3aad016ea48ff0d2ce94cbf604ece0ad89a30fdfb6bd2b6312e3a5fa35f328e83</originalsourceid><addsrcrecordid>eNp9kctO3TAQhi1EBaenvACLyhKbbkJ9ycWnuwq1BQmpG7q2HGdMTBM72A5w3h6noUVi0YU18vib3zPzI3RKyTklpPkcCSk5KwjLp2S1KMQB2tAlRTmvDtGG0IYWFaP1MXof4x3J96phR-iYV7ua8KbcoKebHnALDoxN2BucAqg0gks5ufeuw1PwtwFitN7hR5t6bMdxdoB1D_r35G0mretta5MP8QtWeJyHZAudJSDgACn4OIFO9iHX-N6HhGOau_0H9M6oIcLJS9yiX9-_3VxcFtc_f1xdfL0uNG-qVHClOkJrUKUwhnRMw67UralJCRqI6sROcWI609Ztx9qaUwZcVUbxynAmQPAt-rTq5kHuZ4hJjjZqGAblwM9RsoYwKljDqoyevUHv_Bxc7k4ywakQu2XhW8RWSufJYgAjp2BHFfaSErn4IldfZPZF_vFFLl18fJGe2xG6fyV_jcgAX4GYn9wthNe__yP7DEPJm8M</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2831889004</pqid></control><display><type>article</type><title>The benefit of treatment beyond progression with immune checkpoint inhibitors: a multi-center retrospective cohort study</title><source>Springer Nature</source><creator>Guven, Deniz Can ; Yekeduz, Emre ; Erul, Enes ; Yazgan, Sati Coskun ; Sahin, Taha Koray ; Karatas, Gokturk ; Aksoy, Sercan ; Erman, Mustafa ; Yalcin, Suayib ; Urun, Yuksel ; Kilickap, Saadettin</creator><creatorcontrib>Guven, Deniz Can ; Yekeduz, Emre ; Erul, Enes ; Yazgan, Sati Coskun ; Sahin, Taha Koray ; Karatas, Gokturk ; Aksoy, Sercan ; Erman, Mustafa ; Yalcin, Suayib ; Urun, Yuksel ; Kilickap, Saadettin</creatorcontrib><description>Objective
Treatment beyond progression (TBP) with immune checkpoint inhibitors (ICIs) is an evolving field due to the limitations of conventional imaging in response evaluation. However, real-life data on the benefit of TBP is scarce, especially from the limited resource settings and patients treated in the later lines. Therefore, we aimed to investigate the survival benefit of TBP with ICIs in patients with advanced tumors from a limited resource setting.
Methods
For this multi-center retrospective cohort study, we included 282 patients treated with ICIs and had radiological progression according to RECIST 1.1 criteria. We evaluated post-progression survival according to the use of TBP (TBP and non-TBP groups) with univariate and multivariate analyses.
Results
The cohort’s median age was 61, and 84.4% were treated in the second or later lines. 82 (29.1%) of 282 patients continued on ICIs following the initial progression. In multivariate analyses, patients in the TBP group had improved post-progression survival compared to non-TBP (13.18 vs. 4.63 months, HR: 0.500, 95% CI: 0.349–0.717,
p
< 0.001). The benefit of the TBP was independent of the tumor type, treatment line, and age. Furthermore, TBP with ICIs remained associated with improved post-progression survival (HR: 0.600, 95% CI: 0.380–0.947,
p
= 0.028) after excluding the patients with no further treatment after progression in the non-TBP arm.
Conclusions
In this study, we observed that patients receiving ICIs beyond progression had considerably longer survival. Continuation of ICIs after progression should be considered a reasonable management option for patients with advanced cancer, specifically for patients with limited alternative options.</description><identifier>ISSN: 0171-5216</identifier><identifier>EISSN: 1432-1335</identifier><identifier>DOI: 10.1007/s00432-022-04268-8</identifier><identifier>PMID: 35960374</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cancer Research ; Cohort analysis ; Disease Progression ; Hematology ; Humans ; Immune checkpoint inhibitors ; Immune Checkpoint Inhibitors - therapeutic use ; Internal Medicine ; Lung Neoplasms - pathology ; Medicine ; Medicine & Public Health ; Oncology ; Retrospective Studies ; Survival ; Treatment Outcome</subject><ispartof>Journal of cancer research and clinical oncology, 2023-07, Vol.149 (7), p.3599-3606</ispartof><rights>Crown 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. Crown.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-3aad016ea48ff0d2ce94cbf604ece0ad89a30fdfb6bd2b6312e3a5fa35f328e83</citedby><cites>FETCH-LOGICAL-c375t-3aad016ea48ff0d2ce94cbf604ece0ad89a30fdfb6bd2b6312e3a5fa35f328e83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35960374$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guven, Deniz Can</creatorcontrib><creatorcontrib>Yekeduz, Emre</creatorcontrib><creatorcontrib>Erul, Enes</creatorcontrib><creatorcontrib>Yazgan, Sati Coskun</creatorcontrib><creatorcontrib>Sahin, Taha Koray</creatorcontrib><creatorcontrib>Karatas, Gokturk</creatorcontrib><creatorcontrib>Aksoy, Sercan</creatorcontrib><creatorcontrib>Erman, Mustafa</creatorcontrib><creatorcontrib>Yalcin, Suayib</creatorcontrib><creatorcontrib>Urun, Yuksel</creatorcontrib><creatorcontrib>Kilickap, Saadettin</creatorcontrib><title>The benefit of treatment beyond progression with immune checkpoint inhibitors: a multi-center retrospective cohort study</title><title>Journal of cancer research and clinical oncology</title><addtitle>J Cancer Res Clin Oncol</addtitle><addtitle>J Cancer Res Clin Oncol</addtitle><description>Objective
Treatment beyond progression (TBP) with immune checkpoint inhibitors (ICIs) is an evolving field due to the limitations of conventional imaging in response evaluation. However, real-life data on the benefit of TBP is scarce, especially from the limited resource settings and patients treated in the later lines. Therefore, we aimed to investigate the survival benefit of TBP with ICIs in patients with advanced tumors from a limited resource setting.
Methods
For this multi-center retrospective cohort study, we included 282 patients treated with ICIs and had radiological progression according to RECIST 1.1 criteria. We evaluated post-progression survival according to the use of TBP (TBP and non-TBP groups) with univariate and multivariate analyses.
Results
The cohort’s median age was 61, and 84.4% were treated in the second or later lines. 82 (29.1%) of 282 patients continued on ICIs following the initial progression. In multivariate analyses, patients in the TBP group had improved post-progression survival compared to non-TBP (13.18 vs. 4.63 months, HR: 0.500, 95% CI: 0.349–0.717,
p
< 0.001). The benefit of the TBP was independent of the tumor type, treatment line, and age. Furthermore, TBP with ICIs remained associated with improved post-progression survival (HR: 0.600, 95% CI: 0.380–0.947,
p
= 0.028) after excluding the patients with no further treatment after progression in the non-TBP arm.
Conclusions
In this study, we observed that patients receiving ICIs beyond progression had considerably longer survival. Continuation of ICIs after progression should be considered a reasonable management option for patients with advanced cancer, specifically for patients with limited alternative options.</description><subject>Cancer Research</subject><subject>Cohort analysis</subject><subject>Disease Progression</subject><subject>Hematology</subject><subject>Humans</subject><subject>Immune checkpoint inhibitors</subject><subject>Immune Checkpoint Inhibitors - therapeutic use</subject><subject>Internal Medicine</subject><subject>Lung Neoplasms - pathology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>Treatment Outcome</subject><issn>0171-5216</issn><issn>1432-1335</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kctO3TAQhi1EBaenvACLyhKbbkJ9ycWnuwq1BQmpG7q2HGdMTBM72A5w3h6noUVi0YU18vib3zPzI3RKyTklpPkcCSk5KwjLp2S1KMQB2tAlRTmvDtGG0IYWFaP1MXof4x3J96phR-iYV7ua8KbcoKebHnALDoxN2BucAqg0gks5ufeuw1PwtwFitN7hR5t6bMdxdoB1D_r35G0mretta5MP8QtWeJyHZAudJSDgACn4OIFO9iHX-N6HhGOau_0H9M6oIcLJS9yiX9-_3VxcFtc_f1xdfL0uNG-qVHClOkJrUKUwhnRMw67UralJCRqI6sROcWI609Ztx9qaUwZcVUbxynAmQPAt-rTq5kHuZ4hJjjZqGAblwM9RsoYwKljDqoyevUHv_Bxc7k4ywakQu2XhW8RWSufJYgAjp2BHFfaSErn4IldfZPZF_vFFLl18fJGe2xG6fyV_jcgAX4GYn9wthNe__yP7DEPJm8M</recordid><startdate>20230701</startdate><enddate>20230701</enddate><creator>Guven, Deniz Can</creator><creator>Yekeduz, Emre</creator><creator>Erul, Enes</creator><creator>Yazgan, Sati Coskun</creator><creator>Sahin, Taha Koray</creator><creator>Karatas, Gokturk</creator><creator>Aksoy, Sercan</creator><creator>Erman, Mustafa</creator><creator>Yalcin, Suayib</creator><creator>Urun, Yuksel</creator><creator>Kilickap, Saadettin</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20230701</creationdate><title>The benefit of treatment beyond progression with immune checkpoint inhibitors: a multi-center retrospective cohort study</title><author>Guven, Deniz Can ; Yekeduz, Emre ; Erul, Enes ; Yazgan, Sati Coskun ; Sahin, Taha Koray ; Karatas, Gokturk ; Aksoy, Sercan ; Erman, Mustafa ; Yalcin, Suayib ; Urun, Yuksel ; Kilickap, Saadettin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-3aad016ea48ff0d2ce94cbf604ece0ad89a30fdfb6bd2b6312e3a5fa35f328e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cancer Research</topic><topic>Cohort analysis</topic><topic>Disease Progression</topic><topic>Hematology</topic><topic>Humans</topic><topic>Immune checkpoint inhibitors</topic><topic>Immune Checkpoint Inhibitors - therapeutic use</topic><topic>Internal Medicine</topic><topic>Lung Neoplasms - pathology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Retrospective Studies</topic><topic>Survival</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guven, Deniz Can</creatorcontrib><creatorcontrib>Yekeduz, Emre</creatorcontrib><creatorcontrib>Erul, Enes</creatorcontrib><creatorcontrib>Yazgan, Sati Coskun</creatorcontrib><creatorcontrib>Sahin, Taha Koray</creatorcontrib><creatorcontrib>Karatas, Gokturk</creatorcontrib><creatorcontrib>Aksoy, Sercan</creatorcontrib><creatorcontrib>Erman, Mustafa</creatorcontrib><creatorcontrib>Yalcin, Suayib</creatorcontrib><creatorcontrib>Urun, Yuksel</creatorcontrib><creatorcontrib>Kilickap, Saadettin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest research library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cancer research and clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guven, Deniz Can</au><au>Yekeduz, Emre</au><au>Erul, Enes</au><au>Yazgan, Sati Coskun</au><au>Sahin, Taha Koray</au><au>Karatas, Gokturk</au><au>Aksoy, Sercan</au><au>Erman, Mustafa</au><au>Yalcin, Suayib</au><au>Urun, Yuksel</au><au>Kilickap, Saadettin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The benefit of treatment beyond progression with immune checkpoint inhibitors: a multi-center retrospective cohort study</atitle><jtitle>Journal of cancer research and clinical oncology</jtitle><stitle>J Cancer Res Clin Oncol</stitle><addtitle>J Cancer Res Clin Oncol</addtitle><date>2023-07-01</date><risdate>2023</risdate><volume>149</volume><issue>7</issue><spage>3599</spage><epage>3606</epage><pages>3599-3606</pages><issn>0171-5216</issn><eissn>1432-1335</eissn><abstract>Objective
Treatment beyond progression (TBP) with immune checkpoint inhibitors (ICIs) is an evolving field due to the limitations of conventional imaging in response evaluation. However, real-life data on the benefit of TBP is scarce, especially from the limited resource settings and patients treated in the later lines. Therefore, we aimed to investigate the survival benefit of TBP with ICIs in patients with advanced tumors from a limited resource setting.
Methods
For this multi-center retrospective cohort study, we included 282 patients treated with ICIs and had radiological progression according to RECIST 1.1 criteria. We evaluated post-progression survival according to the use of TBP (TBP and non-TBP groups) with univariate and multivariate analyses.
Results
The cohort’s median age was 61, and 84.4% were treated in the second or later lines. 82 (29.1%) of 282 patients continued on ICIs following the initial progression. In multivariate analyses, patients in the TBP group had improved post-progression survival compared to non-TBP (13.18 vs. 4.63 months, HR: 0.500, 95% CI: 0.349–0.717,
p
< 0.001). The benefit of the TBP was independent of the tumor type, treatment line, and age. Furthermore, TBP with ICIs remained associated with improved post-progression survival (HR: 0.600, 95% CI: 0.380–0.947,
p
= 0.028) after excluding the patients with no further treatment after progression in the non-TBP arm.
Conclusions
In this study, we observed that patients receiving ICIs beyond progression had considerably longer survival. Continuation of ICIs after progression should be considered a reasonable management option for patients with advanced cancer, specifically for patients with limited alternative options.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35960374</pmid><doi>10.1007/s00432-022-04268-8</doi><tpages>8</tpages></addata></record> |
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| subjects | Cancer Research Cohort analysis Disease Progression Hematology Humans Immune checkpoint inhibitors Immune Checkpoint Inhibitors - therapeutic use Internal Medicine Lung Neoplasms - pathology Medicine Medicine & Public Health Oncology Retrospective Studies Survival Treatment Outcome |
| title | The benefit of treatment beyond progression with immune checkpoint inhibitors: a multi-center retrospective cohort study |
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