Immune checkpoint inhibitors (ICI) have improved survival in several cancer types. Still, most patients develop disease progression during or after treatment. We evaluated the reasons for treatment discontinuation and their effect on treatment outcomes in adult patients with advanced cancer with ICI in the first or later treatment lines in Southwest Finland between 1 January 2015 and 31 December 2021. Baseline characteristics and treatment outcomes were retrospectively obtained from the electronic medical records. There were 317 patients with 15 different cancer types, most commonly non-small cell lung cancer, melanoma, and kidney cancer, treated with ICI outside clinical trials. During follow-up, 94% of the patients had discontinued treatment. A total of 62% was due to disease progression, 17% due to immune-related adverse events (irAEs), 12% after achieving disease control or radiological response, and 9% due to poor performance status. The median progression-free survival (mPFS) was 5.4 months and the median overall survival (mOS) was 20.3 months in the whole cohort. Longer mPFS and mOS were observed in patients who discontinued ICI due to irAEs (24.3 and 49.2 months) and after disease control (49.7 months and not reached). In total, 46% of the patients who discontinued ICI after irAEs or disease control remained alive and progression-free during follow-up.
免疫检查点抑制剂（ICI）已改善多种癌症类型的生存率。然而，大多数患者在治疗期间或治疗后仍出现疾病进展。本研究回顾性分析了2015年1月1日至2021年12月31日期间芬兰西南部地区接受一线或后线ICI治疗的晚期癌症成年患者，探讨治疗终止原因及其对疗效的影响。基线特征和治疗结果数据均从电子病历中回溯提取。共纳入317例涵盖15种癌症类型的患者（以非小细胞肺癌、黑色素瘤和肾癌最为常见），均在临床试验外接受ICI治疗。随访期间94%的患者终止治疗，其中62%因疾病进展停药，17%因免疫相关不良事件（irAEs）停药，12%在实现疾病控制或影像学缓解后停药，9%因体能状态恶化停药。全队列中位无进展生存期（mPFS）为5.4个月，中位总生存期（mOS）为20.3个月。因irAEs停药患者的mPFS和mOS显著延长（分别为24.3个月和49.2个月），疾病控制后停药患者更达49.7个月且总生存期未达到。总体而言，在因irAEs或疾病控制停药的患者中，46%在随访期间保持生存且无疾病进展。
肿瘤(癌症)患者之家