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Carmen Esteban

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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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      P1.04-29 - Second or Third Line Nivolumab Versus First Line Nivolumab in Patients with Previously Treated Advanced Non Small Cell Lung Cancer (NSCLC) (ID 13510)

      16:45 - 18:00  |  Author(s): Carmen Esteban

      • Abstract


      The aim of the study was to report outcomes in advanced NSCLS patients treated with Nivolumab after progression to one versus two or three lines of chemotherapy from our everyday clinical practice. Exploratory assessments include the progression-free survival (PFS) and overall survival (OS) , the rates of chemotherapy retreatment after Nivolumab progression and toxicity profile.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Elegibility criteria included, histologically or citologically confirmed stage IV NSCLC without EGFR mutated or ALK traslocated genes treated with Nivolumab when relapsed after 1 versus 2 or 3 prior lines of chemotherapy from January of 2016 to current date.

      4c3880bb027f159e801041b1021e88e8 Result

      From January of 2016 to January of 2018 , a total of 61 patients were enrolled in the study from our Hospital.

      The patients demographics were: median age 63 years, 4,9% (n=3) female and 95% (n=58) male.

      There were 59% ( n=36 ) non squamous-cell and 41% (n=25 ) squamous-cell carcinoma.

      96% (n=59) have received platinum-based therapy previously to Nivolumab : 57% (n=34) combined with Premetrexed and 41% (n=25 ) with other drugs.

      60.7% % (n=37) received Nivolumab at second line and 39.3% (n=24) at 3 or more line .

      45,9 % ( n=28) received chemotherapy after Nivolumab. .These chemotherapy schemes icludes Bevacizumab in 40% of cases

      Grade 1-2 treatment related adverse events (AEs) occurred in 32% patients and the most common ones were endocrine 16% (n=7) and neumonitis 4% ( n=2) but there were one case isolated of grade 3-4 encephalitis, nephritis and hypophysitis

      The 4% ( n=29 patients need to be admitted to the hospital due Nivolumab toxicity versus 16% due to chemotherapy toxicity.

      The median of PFS with Nivolumab was 3 months for both groups IC 95% (2,09-3.9) and median OS for second line Nivolumab was 6 months IC 95% ( 2,7-9,2) and for Nivolumab at 3rd and sucesive lines of 9 months IC 95% ( 3,7-14,2)

      Median PFS for chemotherapy after Nivolumab was 5,3 months ( 2-12 months)

      Median OS was 18 months for second line Nivolumab and 26 months for the other patients and OS for all populaion was 21 months IC 95% (15.2 y 26.7)

      8eea62084ca7e541d918e823422bd82e Conclusion

      Data suggests that Nivolumab is effective and well tolerated in no selected metastatic NSCLC enabling survival of 21 months for these patients with an aceptable toxicity profile .Chemotherapy and antiangiogenic based treatments after Nivolumab are effective and well tolerated.

      This support benefit in heavily chemotherapy pretrated patients: a crucial question that we can not ignore.