Background and Importance While pembrolizumab became a new standard of care in advanced non-small-cell lung cancer (aNSCLC), limited studies proved the effectiveness of continuing use of pembrolizumab after disease progression.

Aim and Objectives We aimed to evaluate the effectiveness of treatment beyond progression (TBP) of pembrolizumab in aNSCLC patients.

Material and Methods This multicentre study retrospectively analysed electronic medical records from databases of two medical centres and two local hospitals. Patients confirmed aNSCLC who received pembrolizumab (monotherapy or combination therapy) and experienced progression disease between 2016 and December 2021 were enrolled. The first date of disease progression after pembrolizumab used was defined as the index date. We defined patients with at least one pembrolizumab within 60 days as TBP group, other patients were defined as switched group. We followed each patient until death, loss of follow-up and end of June 2023. The primary outcome was overall survival (OS), and the baseline characteristic would be adjusted by inverse probability treatment weighting method. We also evaluated prognostic factors, including progression pattern, metastatic sites and baseline characteristics by using a Cox regression model.

Results A total of 307 aNSCLC were included. Among all, 141 (45.9%) continued receiving pembrolizumab beyond progression, while 166 patients (54.1%) switched to other treatments. Overall, median age was 63.3 y/o, 73.3% were male, 90.6% were with ECOG performance 0–1 and 61.3% had high programmed death ligand-1(PD-L1) expression (≥50%). With median 6.2 (2.0–13.1) months follow-up time, the TBP group had a longer OS than the switched group (median OS: 11.1 vs. 4.5 months, P < 0.01).

Conclusion and Relevance While the TBP group was associated with better OS, additional studies are needed to further validate our findings.

Conflict of Interest No conflict of interest.