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Mary Beth Lipka



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    P1.04 - Immunooncology (Not CME Accredited Session) (ID 936)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.04-13 - Combining Clinical and Genomic Data for Predicting Response to Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer (ID 12278)

      16:45 - 18:00  |  Author(s): Mary Beth Lipka

      • Abstract
      • Slides

      Background

      Programmed death receptor (PD-1) inhibitors have emerged as a viable option for several cancers including advanced non-small cell lung cancer (NSCLC) by demonstrating good response rates, increased long-term survival, and a favorable safety profile. Although PD-L1 expression and tumor mutational burden have some role in determining response, these are not always predictive. Therefore identification of other characteristics to predict response to immunotherapy remains of interest and is the focus of this study.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Information from patients with NSCLC treated at UH Cleveland Medical Center has been compiled into a large single institution database. From this prospective database, 116 patients treated with PD-1 inhibitors were identified and their pathological, clinical, and genomic characteristics were gathered. Parameters such as sex, race, smoking status (current vs. former vs. never smoker, years smoking and pack years), and tumor mutational status were statistically analyzed to determine association with response to immunotherapy.

      4c3880bb027f159e801041b1021e88e8 Result

      In this study, 116 patients were treated with PD-1 inhibitors. Overall the response rate to therapy was 22%. Among the 116 patients, 78 had genomic data, which was analyzed and yielded four tumor mutations associated with a clinical response. Of the 6 patients with an NF1 mutation and 6 with an RB1 mutation, none showed a response to treatment (p=0.178). Conversely our analysis showed a positive response to immunotherapy with KRAS and MYC mutations at p-values of 0.098 and 0.018, respectively. MYC mutation remains statistically significant at predicting response when controlling for the effects of age and smoking history.

      Of significant interest we found that a positive response to immunotherapy is associated with positive smoking history and current smoking status. The response rate to immunotherapy was 0% for never smokers, 21.6% for former smokers, and 29.4% for current smokers (p=0.193). Both years smoking and pack years are positively associated with response to immunotherapy with a response increase of 3% per each year smoking (p=0.062).

      8eea62084ca7e541d918e823422bd82e Conclusion

      This study found a positive correlation between response to immunotherapy in patients with NSCLC and ongoing smoking habits as well as overall pack years smoked. It also demonstrated that positive response to therapy is associated with tumor mutations in KRAS and MYC while a lack of response is associated with tumor mutations in NF1 and RB1.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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