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E. De Maio
Poster Display session (Friday) (ID 65)
- Event: ELCC 2018
- Type: Poster Display session
- Presentations: 1
- Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
182P - Real world anti-PD-L1 treatment (tx) outcomes in a multinational European non-small cell lung cancer (NSCLC) cohort with focus on toxicity (tox) and brain metastases (BM): Preliminary data from an EORTC young investigators lung cancer group collaborative analysis (ID 432)
12:30 - 13:00 | Author(s): E. De Maio
Anti-PD-(L)1 (IO) tx has been approved for treating incurable NSCLC patients (pts) in 1st line and beyond. Outcome of pts with BM is not well known as these pts were often excluded from clinical trials. Similarly, there are limited data in pts that discontinue tx due to tox (TOX+). We evaluated outcome of pts with BM at baseline IO (BM+) and IO tox pts in a real world European cohort.
Retrospective multicenter data collection (1 NL, 1 UK, 2 IT) including all consecutive IO treated NSCLC pts. Primary outcomes: progression free and overall survival (PFS/OS) from start IO to progression (PD) or death, respectively of BM+ pts and TOX+ pts (≥gr 2 IO related tox). Secondary: BM development during IO.
Between 05-′15 and 10-′17 150 pts received IO: 26% pembro, 74% nivo. 5.3%, 60.7% and 34% received IO as 1st, 2nd or ≥2 line, respectively. 60.7% male, median age 65.7 years, WHO PS 0-1/2-3/unknown: 89.3/9.3%/1.3%, respectively, 87% current/former smoker, 65% non-squamous histology, 4% EGFR/ALK driver mutation (pretreated with TKI). 25 pts (16.7%) BM+ (1 leptomeningeal (LM), 81% of whom pretreated with radiation), baseline characteristics did not significantly differ between BM+ and BM−. 12.6% of all pts developed/had PD of BM during IO. Median FU was 7.8 months (mo). Median PFS was 11.7 vs 4.6 mo (p < 0.001) for BM+ vs BM-, median PFS of the LM pt was 0.3 mo. Median OS was not reached for BM+ pts and was 9.4 mo for BM- pts (p < 0.001). 46 pts (30.6%) had grade ≥ 2 IO related tox, 13 pts (8.7%) discontinued IO without having PD (76.9% grade ≥3). Median time on IO for TOX+ discontinuing pts was 4.8 mo. 38.5% of the TOX+ pts had PD after discontinuation. Median PFS and OS of TOX+ vs TOX- pts was 16.3 vs 10.2 and 17.7 vs 15.0 mo respectively with a trend towards longer survival for TOX+ pts (both p ns).
With limited FU, (irradiated) BM+ is not a negative prognostic marker in IO treated pts, as PFS/OS are significantly longer compared to BM-. Development/PD of BM during IO is low. Discontinuation because of tox while responding does not negatively impact on survival in most pts.
Clinical trial identification:
Legal entity responsible for the study:
Has not received any funding
All authors have declared no conflicts of interest.
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