Systemic and oligo-acquired resistance to PD-(L)1 blockade in lung cancer Journal Article


Authors: Schoenfeld, A. J.; Rizvi, H. A.; Memon, D.; Shaverdian, N.; Bott, M. J.; Sauter, J. L.; Tsai, C. J.; Lihm, J.; Hoyos, D.; Plodkowski, A. J.; Perez-Johnston, R.; Sawan, P.; Egger, J. V.; Greenbaum, B. D.; Rimner, A.; Riely, G. J.; Rudin, C. M.; Rusch, V. W.; Gomez, D. R.; Hellmann, M. D.
Article Title: Systemic and oligo-acquired resistance to PD-(L)1 blockade in lung cancer
Abstract: Purpose: Clinical patterns and the associated optimal managesAR (P < 0.001, P 1⁄4 0.03, P 1⁄4 0.04, respectively), whereas ment of acquired resistance to PD-(L)1 blockade are poorly baseline PD-L1 and tumor burden were similar. Post-progresunderstood. sion, oligoAR was associated with improved overall survival Experimental Design: All cases of metastatic lung cancer treated (median 28 months vs. 10 months, P < 0.001) compared with with PD-(L)1 blockade at Memorial Sloan Kettering were reviewed. sAR. Within oligoAR, post-progression survival was greater In acquired resistance (complete/partial response per RECIST, among patients treated with locally-directed therapy (e.g., radifollowed by progression), clinical patterns were distinguished as ation, surgery; HR, 0.41; P 1⁄4 0.039). Fifty-eight percent of oligo (OligoAR ≤ 3 lesions of disease progression) or systemic patients with oligoAR treated with locally-directed therapy (sAR). We analyzed the relationships between patient character-alone are progression-free at last follow-up (median 16 months), istics, burden/location of disease, outcomes, and efficacy of theraincluding 13 patients who are progression-free more than 2 years peutic interventions. after local therapy. Results: Of 1,536 patients, 312 (20%) had an initial response Conclusions: OligoAR is a common and distinct pattern of and 143 developed AR (9% overall, 46% of responders). Oliacquired resistance to PD-(L)1 blockade compared with sAR. goAR was the most common pattern (80/143, 56%). Baseline OligoAR is associated with improved post-progression survival and tumor mutational burden, depth of response, and duration of some cases can be effectively managed with local therapies with response were significantly increased in oligoAR compared with durable benefit. ©2022 American Association for Cancer Research.
Keywords: tumor volume; carcinoma, non-small-cell lung; lung neoplasms; pathology; tumor marker; lung tumor; immunotherapy; tumor burden; programmed death 1 ligand 1; non small cell lung cancer; humans; human; biomarkers, tumor; b7-h1 antigen
Journal Title: Clinical Cancer Research
Volume: 28
Issue: 17
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2022-09-01
Start Page: 3797
End Page: 3803
Language: English
DOI: 10.1158/1078-0432.Ccr-22-0657
PUBMED: 35767426
PROVIDER: scopus
PMCID: PMC10448606
DOI/URL:
Notes: Article -- Export Date: 3 October 2022 -- Source: Scopus
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MSK Authors
  1. Valerie W Rusch
    865 Rusch
  2. Daniel R Gomez
    237 Gomez
  3. Gregory J Riely
    599 Riely
  4. Andreas Rimner
    524 Rimner
  5. Matthew Bott
    135 Bott
  6. Matthew David Hellmann
    411 Hellmann
  7. Charles Rudin
    489 Rudin
  8. Chiaojung Jillian   Tsai
    239 Tsai
  9. Hira Abbas Rizvi
    122 Rizvi
  10. Peter Sawan
    20 Sawan
  11. Jennifer Lynn Sauter
    124 Sauter
  12. Jacklynn V Egger
    68 Egger
  13. David Hoyos
    15 Hoyos
  14. Jayon Lihm
    10 Lihm