Virtual Library

Start Your Search

Andrew G Robinson



Author of

  • +

    MA10 - Considerations in Immunotherapy / Real World (ID 911)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Advanced NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 10:30 - 12:00, Room 105
    • +

      MA10.08 - Choice of Taxane and Outcomes in the KEYNOTE-407 Study of Pembrolizumab Plus Chemotherapy for Metastatic Squamous NSCLC (ID 14698)

      11:25 - 11:30  |  Author(s): Andrew G Robinson

      • Abstract
      • Presentation
      • Slides

      Background

      In the randomized, double-blind, phase 3 KEYNOTE-407 study (NCT02775435), pembrolizumab plus chemotherapy with carboplatin and paclitaxel or nab-paclitaxel significantly prolonged OS (HR 0.64, 95% CI 0.49-0.85, P=0.0008) and PFS (HR 0.56, 95% CI 0.45-0.70, P<0.0001) compared with placebo plus chemotherapy in patients with previously untreated, metastatic squamous NSCLC. The benefit of pembrolizumab plus chemotherapy was observed irrespective of PD-L1 TPS. Pembrolizumab plus chemotherapy also had a manageable safety profile. We performed an exploratory analysis of outcomes by investigator’s choice of paclitaxel or nab-paclitaxel, which was a randomization stratification factor.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      559 eligible patients were randomized 1:1 to pembrolizumab 200 mg or placebo Q3W for up to 35 cycles plus 4 cycles of carboplatin AUC 6 mg/mL/min Q3W and investigator’s choice of paclitaxel 200 mg/m2 Q3W or nab-paclitaxel 100 mg/m2 QW. Primary end points were OS and PFS; ORR and safety were secondary.

      4c3880bb027f159e801041b1021e88e8 Result

      Paclitaxel was the chosen taxane in 60% of patients. The addition of pembrolizumab to chemotherapy improved OS, PFS, and ORR regardless of choice of carboplatin and paclitaxel or carboplatin and nab-paclitaxel (Table). Incidence of grade 3-5 AEs in the pembrolizumab plus chemotherapy arm vs placebo plus chemotherapy arm was 63.9% vs 59.3% in paclitaxel recipients and 78.9% vs 81.4% in nab-paclitaxel recipients. AEs led to discontinuation of all treatment in 13.6% vs 8.4% of paclitaxel recipients and 12.8% vs 3.5% of nab-paclitaxel recipients and led to discontinuation of any treatment in 19.5% vs 13.2% and 29.4% vs 9.7%, respectively. Immune-mediated AEs occurred in 29.6% vs 9.6% of paclitaxel recipients and 27.5% vs 7.1% of nab-paclitaxel recipients.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Adding pembrolizumab to chemotherapy with carboplatin and a taxane improved efficacy and was generally tolerable compared with chemotherapy alone as first-line therapy in patients with metastatic squamous NSCLC regardless of whether paclitaxel or nab-paclitaxel was the chosen taxane.

      Carboplatin plus Paclitaxel Carboplatin plus Nab-Paclitaxel

      Pembrolizumab + Chemotherapy

      N = 169

      Placebo + Chemotherapy

      N = 167

      Pembrolizumab + Chemotherapy

      N = 109

      Placebo + Chemotherapy

      N = 114

      OS, median

      (95% CI), mo

      14.0 (12.6-16.6) 10.3 (8.2-14.8) NR (NE-NE) 12.6 (9.6-NE)
      HR (95% CI)a 0.67 (0.48-0.93) 0.59 (0.36-0.98)

      PFS, median

      (95% CI), mo

      6.4 (6.0-8.3) 4.4 (4.2-5.1) 6.5 (6.2-8.5) 5.9 (4.4-6.9)
      HR (95% CI)a 0.52 (0.40-0.68) 0.65 (0.45-0.94)
      ORR, % (95% CI) 57.4 (49.6-65.0) 37.7 (30.4-45.5) 58.7 (48.9-68.1) 39.5 (30.4-49.1)
      aBased on a Cox regression model with treatment as a covariate.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    MTE12 - IO in the Real World - High Risk Populations And Patient Support (Ticketed Session) (ID 822)

    • Event: WCLC 2018
    • Type: Meet the Expert Session
    • Track: Immunooncology
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 07:00 - 08:00, Room 206 AC
    • +

      MTE12.01 - Is IO an Option for Patients with Contraindications (Auto-immune Disease, Pulmonary Fibrosis, HIV, Hepatitis, Transplant etc) (ID 11566)

      07:00 - 07:40  |  Presenting Author(s): Andrew G Robinson

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

  • +

    P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
    • +

      P3.01-04 - Immune Checkpoint Inhibitors (ICIs) in NSCLC: Immune Related Adverse Events (irAEs) and Outcomes. A Canadian Single Institution Experience. (ID 12522)

      12:00 - 13:30  |  Author(s): Andrew G Robinson

      • Abstract
      • Slides

      Background

      The ICIs are a major therapeutic advance in NSCLC with recognized toxicity in the form of irAEs. The association between irAEs and clinical benefit remains unclear but promising. The aim of this study was to examine the incidence and nature of of irAEs and correlative outcomes in patients treated with ICIs for advanced/recurrent NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A retrospective chart review of all advanced NSCLC patients treated with immunotherapy between January 2015 to December 2016 was undertaken. Treatment was either on a clinical trial or as a standard of care. Patient demographics, clinical, pathological, and radiological parameters were assessed and an exploratory analysis was conducted to review these factors and outcomes in patients with and without irAEs. The nature and timing of the irAES was also evaluated.

      4c3880bb027f159e801041b1021e88e8 Result

      47 patients had ICIs: 24 (51%) received either Nivolumab, Pembrolizumab or Durvalumab alone (SAIO), 15 (32%) had dual agent immunotherapy (DAIO), 8 (17%) had chemotherapy plus ICI. 26 pts (55.3%) were female; median age was 65 years (range 50-90), 15 (31%) had squamous NSCLC. Median months (m) of ICI treatment were 5 (1 – 32). 21/47 (45%) were alive at 1 year. IrAEs occurred in 29 patients (61.7%), 13% SAIO, 23% DAIOs and 15% chemotherapy plus ICI. IrAEs were: dermatological (n=13), diarrhea/colitis (n=10/1), thyroid dysfunction (n=9), and pneumonitis (n=8), hypophysitis (n=1) and nephritis (n=1). The earliest irAE was dermatological with a median onset of 6 weeks. In those with irAEs versus (v) no irAEs: RR = 55% v 11%, disease control rate (DCR) 76% v 33%. 13/29 (45%) had an irAE in ≤ 6 weeks: RR = 38%, DCR = 53% and 6 of these (46%) were alive at 1 year. 21 patients were alive at 1 year: 16/21 (76%) had an irAE and of these, 13/16 (81%) had 2 irAES or irAEs ≥ grade (G) 2. Median overall survival (OS) for all patients was 9m (6.3-11.7). Landmark analysis at 3m: median OS for no irAES v irAEs was 15m v 18 m, log rank p=0.76. Median survival of those with no irAE v G1 v ≥ G2 was 2m v 8m v 23m, log rank p= 0.014. Further correlative outcome data will be presented.

      8eea62084ca7e541d918e823422bd82e Conclusion

      A landmark analysis at 3m did not show a statistically significant correlation between irAEs and survival. This merits further study as does the suggestion of a correlation between number of irAEs and grade with regards to outcome.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.