Journal Article DKFZ-2026-02422

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Lung cancer after allogeneic hematopoietic stem cell transplantation.

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2026
Elsevier Amsterdam [u.a.]

Lung cancer 221, 109633 () [10.1016/j.lungcan.2026.109633]
 GO

Abstract: Long-term outcomes of allogeneic hematopoietic cell transplantation (HCT) are improving, increasing the relevance of secondary malignancies, including lung cancer. The clinical utility of immune checkpoint inhibitors (ICIs) in this setting remains unclear and concerns regarding graft-versus-host disease (GvHD) persist.In this international cohort study, we evaluated clinical characteristics, survival outcomes, and toxicities in patients diagnosed with non-small cell lung cancer (NSCLC) or small-cell lung cancer (SCLC) and a history of HCT.A total of 77 patients from 18 centers in six countries were included. Median time from HCT to diagnosis was 4.2 years (95%CI, 0.5-30.4), 64% of patients were male, and 81% were current or former smokers. In advanced NSCLC, patients treated with ICI-based therapies (n=20) had longer overall survival than those receiving chemotherapy alone (n=16) (median 17.4 vs 4.7 months; HR 0.32, 95%CI: 0.13-0.77). Across 77 lines of therapy in 54 patients receiving systemic treatment, grade 3-5 immune-related adverse events (irAEs) or GvHD occurred in 2/30 ICI-containing lines (7%) and 1/47 lines that did not include ICIs (2%). However, patients receiving ICIs had longer intervals from HCT to treatment initiation (median, 7.1 vs 3.0 years) and did not require GvHD treatment (0% vs 25%), indicating improved host immune tolerance.In our study, ICI-based therapies were associated with prolonged survival in selected patients with advanced NSCLC and presumed host immune tolerance. We did not observe a clear signal of excess irAEs/GvHD. Our results support considering the use of ICIs in this population.

Keyword(s): Allogeneic hematopoietic cell transplantation ; Immune checkpoint inhibitors ; Lung Cancer ; PD-(L)1 inhibitors

Classification:

Note: #NCTZFB26#

Contributing Institute(s):
  1. Personalisierte Medizinische Onkologie (A420)
  2. Koordinierungsstelle NCT SüdWest (SW01)
Research Program(s):
  1. 311 - Zellbiologie und Tumorbiologie (POF4-311) (POF4-311)

Appears in the scientific report 2026
Database coverage:
Medline ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; NationallizenzNationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
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 Record created 2026-10-01, last modified 2026-10-05



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