ArticleJournal for immunotherapy of cancer2020
Early tumor shrinkage identifies long-term disease control and survival in patients with lung cancer treated with atezolizumab.
Article in Journal for immunotherapy of cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 32 citations in OpenAlex.
- Evaluation of hyperprogressive disease with atezolizumab plus bevacizumab for hepatocellular carcinoma: A secondary analysis of the IMbrave150 trial.International journal of cancer · 2025Trial
- First-line pembrolizumab plus chemotherapy for advanced/metastatic esophageal cancer: 1-year extended follow-up in the Japanese subgroup of the phase 3 KEYNOTE-590 study.Esophagus : official journal of the Japan Esophageal Society · 2024Trial
- Early tumor shrinkage and depth of response in patients with metastatic esophageal cancer treated with 2-weekly docetaxel combined with cisplatin plus fluorouracil: an exploratory analysis of the JCOG0807.Esophagus : official journal of the Japan Esophageal Society · 2023Trial
- Integrative evaluation of primary and metastatic lesion spectrum to guide anti-PD-L1 therapy of non-small cell lung cancer: results from two randomized studies.Oncoimmunology · 2021Trial
- Early Tumor Shrinkage and Clinical Outcomes for Esophageal Squamous Cell Carcinoma Patients Treated with Immune Checkpoint Inhibitors: Real-World Observational Study.Annals of surgical oncology · 2026Observational
- ASO Author Reflections: Early Tumor Shrinkage: An Early Signal of Benefit From Immune Checkpoint Inhibitors in ESCC.Annals of surgical oncology · 2026Article
- Mathematical and Mouse Models Identify Regulatory T Cell Influx as A Key Determinant of Acquired Resistance to PD-1 Immunotherapy.Cancer research · 2026Article
- Integrating Mathematical and Mouse Models Identifies T Regulatory Cell Influx as A Key Determinant of Acquired Resistance to PD-1 Immunotherapy.bioRxiv : the preprint server for biology · 2025Article
- Early Tumor Shrinkage and Depth of Response as Predictive Markers of Treatment Response and Prognosis in Solid Tumors.Cancer medicine · 2025Review
- Multi-stage mechanisms of tumor metastasis and therapeutic strategies.Signal transduction and targeted therapy · 2024Review
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- Comparison of sequential and joint nonlinear mixed effects modeling of tumor kinetics and survival following Durvalumab treatment in patients with metastatic urothelial carcinoma.Journal of pharmacokinetics and pharmacodynamics · 2023Article
- Optimizing the tumor shrinkage threshold for evaluating immunotherapy efficacy for advanced non-small-cell lung cancer.Journal of cancer research and clinical oncology · 2023Article
- The prognostic role of early tumor shrinkage in patients with hepatocellular carcinoma undergoing immunotherapy.Cancer imaging : the official publication of the International Cancer Imaging Society · 2022Article
- Retrospective analysis of long-term survival factors in patients with advanced non-small cell lung cancer treated with nivolumab.Thoracic cancer · 2022Article
- Prognostic impact of early tumor shrinkage and depth of response in patients with microsatellite instability-high metastatic colorectal cancer receiving immune checkpoint inhibitors.Journal for immunotherapy of cancer · 2021Article
- Application of Machine Learning for Tumor Growth Inhibition - Overall Survival Modeling Platform.CPT: pharmacometrics & systems pharmacology · 2021Article
- Neutrophil-to-Lymphocyte Ratio and Early Tumor Shrinkage as Predictive Biomarkers in Unresectable Hepatocellular Carcinoma Patients Treated With Lenvatinib, PD-1 Inhibitors, in Combination With TACE.Technology in cancer research & treatmentObservational
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPreliminary evidence indicates that early tumor shrinkage (ETS) following immune checkpoint inhibitor (ICI) initiation may be associated with survival outcomes in patients with advanced melanoma. ETS has not been explored as a biomarker of survival outcomes or patient-reported outcomes in patients with advanced non-small cell lung cancer (NSCLC) treated with ICIs.
methodsThe study pooled data from patients with NSCLC in the randomized trials OAK and POPLAR (atezolizumab vs docetaxel; n=1464), and single-arm atezolizumab trials BIRCH and FIR (n=797). The association between ETS (≥10% decrease in pretreatment sum-of-longest diameters of target-lesions at 6 weeks) and overall survival (OS), progression-free survival (PFS), time to deterioration (TDD) in health-related quality-of-life (HRQoL) and physical function (PF) was assessed using Cox proportional hazard analysis.
resultsETS occurred in 20% of atezolizumab-treated patients with NSCLC within OAK and POPLAR and was associated with highly favorable OS (HR 0.33, p<0.001), PFS (HR 0.31, p<0.001), TDD in HRQoL (HR 0.73, p=0.01) and PF (HR 0.52, p<0.001). The results were replicated in the BIRCH and FIR data. Atezolizumab-treated patients achieving ETS had markedly improved OS compared with docetaxel-treated patients achieving ETS (24-month OS 55% vs 32%); PFS was also markedly improved (24-month PFS 31% vs 4%). In contrast, for patients not achieving ETS, atezolizumab-treatment was associated with more modest OS (24-month OS 23% vs 20%) and PFS (24-month PFS 3% vs 1%) improvement compared with docetaxel. Overall, the effect size for ETS within the atezolizumab-treated patients was significantly greater than that in the docetaxel-treated patients (P(interaction)=0.002 for OS and P(interaction)<0.001 for PFS).
conclusionsETS is an easily measurable biomarker, predictive of highly favorable survival and patient-reported outcomes with atezolizumab treatment for advanced NSCLC. Further, ETS identifies patients with significantly greater treatment benefit for ICI therapy.
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