在过去几年里，免疫检查点抑制剂（ICI）的出现彻底改变了非小细胞肺癌（NSCLC）的治疗方式。在临终安宁的患者中，之前的预后非常不佳，但现在有可能在很多年内出现显著的反应。然而，ICI治疗非常昂贵，并且需要频繁接触医疗资源。一些早期试验方案将ICI治疗时间限制为两年。现在这些研究的随访数据已经出现，并揭示了在成功完成两年疗程后，患者在两年或更长时间内不需要进一步治疗而仍能持续反应的可能性。我们现在是否可以勇敢地考虑（并提及）在临终安宁的情况下治愈的可能性？这是否意味着我们可以在初始两年治疗后停止ICI治疗？在本综述中，我们试图提高对这一患者群体的临床决策信心。为此，我们评估了治疗时间限制为两年的试验以及其他考虑在反应良好的患者中终止ICI的数据。高达25%的患者成功完成了两年的ICI疗程。在这一组患者中，约40-46%的患者无需进一步治疗就在五年内存活，五年生存率高达83%。关于ICI再挑战的数据很少，但似乎其疗效与初次接触时不同。目前没有确定的生物标志物可用于辅助决策。可能的未来（生物学）标志物，如PD-L1、突变、循环肿瘤DNA（ctDNA）或正电子发射断层扫描（PET）需要在前瞻性研究中进一步评估。总之，我们建议认真考虑在肿瘤反应患者中停止ICI治疗的概念，因为这可能对我们的患者和卫生保健系统有益。版权所有©2023 Elsevier B.V.出版。

Over the last years, the emergence of immune checkpoint inhibitors (ICI) has revolutionized the treatment of non-small cell lung cancer (NSCLC). Patients in a palliative setting with previously very poor prognosis may now show remarkable responses over years. Yet, ICI therapy is very cost-intensive and involves frequent contacts with healthcare resources. Some of the early trial protocols restricted ICI treatment duration to two years. Now follow-up data of these studies is available and reveal the possibility of a persistent response after two or more years without further treatment for patients having successfully completed two years of therapy. May we now dare to think (and speak) of cure in the palliative setting? Does it mean we can stop ICI therapy after an initial two-year treatment? In this review, we try to improve confidence in clinical decision-making for this patient group. To this end, trials with a restricted treatment duration of two years and other data considering potential ICI discontinuation in responding patients were evaluated. Up to 25% of patients successfully complete an initial two-year course of ICI. Within this group about 40-46% of patients are alive at five years without further treatment with five-year survival rates of up to 83%. Data on ICI rechallenge are scarce, yet it does not seem to provide the same level of efficacy as at first exposure. At present there are no established biomarkers to help with decision-making. Possible future (bio-)markers, such as PD-L1, mutations, circulating tumor DNA (ctDNA) or Positron emission tomography (PET) need to be evaluated further in a prospective setting. In conclusion, we propose that the concept of discontinuing ICI therapy in patients with tumor response has to be seriously taken into consideration as it may be of benefit to our patients and health care systems.Copyright © 2023. Published by Elsevier B.V.