{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T23:13:08Z","timestamp":1793056388778,"version":"4.5.0"},"reference-count":17,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"\n Importance<\/jats:title>\n For patients with advanced non\u2013small cell lung cancer (NSCLC) treated with frontline immunotherapy-based treatment, the optimal duration of immune checkpoint inhibitor (ICI) treatment is unknown.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess practice patterns surrounding ICI treatment discontinuation at 2 years and to evaluate the association of duration of therapy with overall survival in patients who received fixed-duration ICI therapy for 2 years vs those who continued therapy beyond 2 years.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective, population-based cohort study included adult patients in a clinical database diagnosed with advanced NSCLC from 2016 to 2020, who received frontline immunotherapy-based treatment. The data cutoff was August 31, 2022; data analysis was conducted from October 2022 to January 2023.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n \n Treatment discontinuation at 2 years (between 700 and 760 days,\n fixed duration<\/jats:italic>\n ) vs continued treatment beyond 2 years (greater than 760 days,\n indefinite duration<\/jats:italic>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Overall survival from 760 days was analyzed using Kaplan-Meier methods. Multivariable Cox regression that adjusted for patient-specific and cancer-specific factors was used to compare survival beyond 760 days between the fixed-duration group and the indefinite-duration group.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 1091 patients in the analytic cohort who were still on ICI treatment at 2 years after exclusion criteria for death and progression were applied, 113 patients (median [IQR] age, 69 [62-75] years; 62 [54.9%] female; 86 [76.1%] White) were in the fixed-duration group, and 593 patients (median [IQR] age, 69 [62-76] years; 282 [47.6%] female; 414 [69.8%] White) were in the indefinite-duration group. Patients in the fixed-duration group were more likely to have a history of smoking (99% vs 93%;\n P<\/jats:italic>\n \u2009=\u2009.01) and be treated at an academic center (22% vs 11%;\n P<\/jats:italic>\n \u2009=\u2009.001). Two-year overall survival from 760 days was 79% (95% CI, 66%-87%) in the fixed-duration group and 81% (95% CI, 77%-85%) in the indefinite-duration group. There was no statistically significant difference in overall survival between patients in the fixed-duration and indefinite-duration groups, either on univariate (hazard ratio [HR] 1.26; 95% CI, 0.77-2.08;\n P<\/jats:italic>\n \u2009=\u2009.36) or multivariable (HR 1.33; 95% CI, 0.78-2.25;\n P<\/jats:italic>\n \u2009=\u2009.29) Cox regression. Approximately 1 in 5 patients discontinued immunotherapy at 2 years in the absence of progression.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In a retrospective clinical cohort of patients with advanced NSCLC who were treated with immunotherapy and were progression-free at 2 years, approximately only 1 in 5 discontinued treatment. The lack of statistically significant overall survival advantage for the indefinite-duration cohort on adjusted analysis provides reassurance to patients and clinicians who wish to discontinue immunotherapy at 2 years.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoncol.2023.1891","type":"journal-article","created":{"date-parts":[[2023,6,4]],"date-time":"2023-06-04T09:30:44Z","timestamp":1685871044000},"page":"1075","source":"Crossref","is-referenced-by-count":158,"title":["Association Between Duration of Immunotherapy and Overall Survival in Advanced Non\u2013Small Cell Lung Cancer"],"prefix":"10.1001","volume":"9","author":[{"given":"Lova","family":"Sun","sequence":"first","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Bleiberg","sequence":"additional","affiliation":[{"name":"Division of 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