ArticleESMO open2025
Immunotherapy beyond progression combined with platinum-based chemotherapy after primary resistance to first-line immunotherapy in patients with advanced NSCLC and PD-L1 ≥50.
Article in ESMO open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Therapeutic vaccines for NSCLC: From mechanisms to clinical translation.Chinese medical journal pulmonary and critical care medicine · 2026Review
- Multi-omics biomarkers for predicting resistance, hyperprogression, and immune-related toxicity during PD-1/PD-L1 therapy in lung cancer: a literature review.Frontiers in immunology · 2026Review
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrimary resistance to immune checkpoint inhibitors (ICIs) remains a major challenge in patients with advanced non-small-cell lung cancer (NSCLC) and programmed death-ligand 1 (PD-L1) expression ≥50%. The benefit of continuing ICIs beyond progression in combination with chemotherapy is unclear. PATIENTS AND
methodsThis multicenter retrospective study included patients with advanced NSCLC and PD-L1 ≥50% treated with first-line ICI monotherapy at five European centers. Primary resistance was defined as progressive disease as best response or stable disease lasting <6 months. Outcomes of second-line platinum-based chemotherapy alone or combined with ICI were compared. The primary endpoint was progression-free survival 2, defined as time from first-line ICI initiation to second-line progression or death.
resultsAmong 293 eligible patients, 119 (38%) showed primary resistance. Compared with those who did not develop primary resistance, patients with primary resistance more often had multisite progression (74% versus 42%) and less often oligoprogression (13% versus 54%) (P < 0.001). Second-line platinum-based chemotherapy was administered to 43.7% (52/119) of patients with primary resistance, 34.6% (18/52) of whom received ICI beyond progression. Baseline characteristics were comparable across treatment groups. Patients who received ICI beyond progression, compared with those who received only chemotherapy, had significantly longer median progression-free survival 2 (12.3 versus 7.0 months, P < 0.001) and OS (21.8 versus 10.1 months, P = 0.007), with similar overall response rate (66.7% versus 39.3%, P = 0.13). No relevant safety signals emerged.
conclusionIn patients with NSCLC and PD-L1 ≥50% showing primary resistance to first-line ICI, continuing immunotherapy beyond progression combined with chemotherapy may improve survival outcomes. These findings should be considered hypothesis-generating and warrant prospective confirmation.
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