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D. McCune



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    P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P2.01-003 - T-Cytotoxic Specific Immunotherapy in NSCLC with Brain Metastases NCT00104780 (ID 1202)

      09:30 - 17:00  |  Author(s): D. McCune

      • Abstract
      • Slides

      Background:
      Brain metastases (BM) come with poor prognosis (median survival 3 to 6 months) and data are lacking as patients are often excluded from clinical trials.

      Methods:
      We present the results of a subgroup of NSCLC patients with BM treated with OSE-2101 (T-cytotoxic specific immunotherapy combining 9 epitopes targeting 5 tumor associated antigens and 1 pan-DR epitope) during a phase IIb study of OSE-2101 (1 injection per 3 week for 6 injections followed by 1 injection every 2 to 3 months) in advanced stage IIIB and IV NSCLC (Barve et al. 2008. J Clin Oncol 26:4418-4425). Patients were eligible whatever the number of prior chemotherapy (chemo) lines (65.5% entering 3rd line) and patients with stable BM for 2 months could be included. Six out of 64 treated patients had BM prior to inclusion and are reviewed.

      Results:

      Table 1: NSCLC patients included with BM
      Patient 108 150 169 132 133 135
      Gender F M M M M M
      Ethnic origin CAU CAU CAU CAU AA CAU
      Age (years) 46 61 58 79 46 57
      ECOG performance status 1 1 1 1 1 1
      Previous treatment RT 30 Gy Chemo 2 lines WBRT 30 Gy Chemo 2 lines RT 30 Gy Chemo 2 lines WBRT 30 Gy Chemo 3 lines RT 30 Gy Chemo 1 line WBRT 30 Gy Chemo 3 lines
      AA: African-American, CAU: Caucasian, Chemo: chemotherapy, F: female, Gy: Gray, M: male, RT: radiotherapy, WBRT: whole brain radiotherapy Table 2: Response to therapy
      Patient 108 150 169 132 133 135
      OS 30.16 mo 41 mo* 16.5 mo 9.6 mo 11 mo 7 mo**
      Time without progression 11.57 mo 24.39 mo 11.9 mo 4.53 mo 6.2 mo 2 mo*[2]
      CTL response (positive epitopes out of 5 tested) 3 2 5 2 1 Not tested
      HTL response + + + - - Not tested
      * Patient still alive at the time of the last follow up, ** treatment stopped after 2 injections for progressive disease. CTL: cytotoxic T lymphocytes, HTL: helper T lymphocytes, mo: months, OS: Overall survival, The 6 BM patients present long survival (median 13 mo, range 7-41) considering the advanced stage and the poor prognosis of these heavily pretreated patients. All patients had received from 1 to 3 previous chemo lines. Evaluation of CTL responses to 5 epitopes of OSE-2101 in 5 patients shows that each patient had a CTL response to at least one and up to 5 epitopes. Surprisingly patients with positive HTL response (patient 108, 150, 169) achieve the longest OS when compared with negative HTL patients (132 and 133).

      Conclusion:
      Long OS has been documented in NSCLC patients with BM treated with T-specific immunotherapy following RT and 1 to 3 previous chemo lines.

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