Some Lung Cancer Patients Achieve Long-Term Disease Control After Stopping Immunotherapy

Recent research indicates that a subset of patients with non-small cell lung cancer (NSCLC) can maintain disease control even after discontinuing immune checkpoint inhibitor (ICI) therapy. This is particularly relevant for patients who cease treatment due to immune-related adverse events (irAEs), such as pneumonitis, colitis, or hepatitis, which can sometimes lead to permanent stopping of therapy.

Immune checkpoint inhibitors have transformed the treatment landscape for NSCLC, offering improved survival rates across both early and advanced stages. However, their activation of the immune system may cause irAEs, raising questions about when to pause or stop treatment. Overall, between 3% and 12% of patients receiving single-agent ICIs and up to 25% on combination therapies may need to halt treatment because of side effects.

A study analyzing data from 2,794 patients across multiple institutions found that roughly 10% discontinued ICIs due to irAEs. Remarkably, these patients experienced a median progression-free survival of 12.7 months and an overall survival of 43.7 months after stopping therapy. Such findings suggest that many patients can enjoy prolonged disease stability and survival even after discontinuation.

Factors associated with better outcomes included high PD-L1 expression, achieving a complete or partial response, and longer treatment durations (more than three months). Conversely, certain tumor characteristics, like nonsquamous histology, also correlated with extended survival. Importantly, the use of steroids or immunosuppressants for irAEs did not appear to negatively impact these outcomes, indicating that managing side effects does not necessarily compromise cancer control.

Dr. Mark Awad, senior author and chief of Thoracic Oncology at Memorial Sloan Kettering, emphasizes that understanding these factors can help clinicians make more informed decisions about stopping therapy and predicting patient prognosis. The study supports that some patients can safely pause immunotherapy without risking disease progression, which is crucial when balancing treatment benefits with quality of life considerations.

While severe irAEs warrant immediate discontinuation, managing intermediate-grade effects remains complex. These findings aim to guide personalized treatment plans and provide reassurance about stopping ICIs when necessary. However, the retrospective nature of the study warrants cautious interpretation, and further prospective research is needed.

In summary, ongoing research highlights that certain lung cancer patients can achieve durable disease control even after stopping immunotherapy. This can lead to more nuanced, individualized approaches to treatment management in NSCLC.

Source: https://medicalxpress.com/news/2025-04-lung-cancer-patients-durable-disease.html