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Rosa Álvarez Álvarez
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P1.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 947)
- 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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P1.15-03 - Clinical Characteristics of Long-Term Survivors With Nivolumab in Pretreated Advanced NSCLC<br /> from Real-World Data (RWD) (ID 14154)
16:45 - 18:00 | Author(s): Rosa Álvarez Álvarez
- Abstract
Background
We have previously analyzed real-world data (RWD) from patients with metastatic NSCLC that progressed to chemotherapy and were subsequently treated with immune-checkpoint inhibitors (ICI). This included patients with performance status of 2, brain metastases, concomitant use of steroids, unknown PD-L1 status, systemic antibiotics during the previous month, and without restriction in the number of previous lines received. Now, with a longer follow-up, we aimed to analyze the baseline clinical characteristics in long-term survivor patients.
a9ded1e5ce5d75814730bb4caaf49419 Method
We performed a retrospective study of previously treated advanced NSCLC patients that received nivolumab at 3 mg/kg every 2 weeks outside clinical trials from our institution in Madrid (Spain) between January 2015 and April 2018. We used RWD to analyze the clinical characteristics of patients who were alive 2 years after the start of ICI.
4c3880bb027f159e801041b1021e88e8 Result
A total of 38 pts fulfilled inclusion criteria. 7 pts (18%) where alive 2 years after the first dose of nivolumab. Median age at diagnosis was 63 years (53-72 years). 6 pts (86%) had history of tobacco smoking, and 6 pts (86%) had non-squamous histology. 3 pt had ECOG 0 (43%), 3 pts had ECOG 1 (43%) and one pt had ECOG 2 (14%). Median number of previous lines was 3; 3 pts received nivolumab in second line, 3 pts in fourth line and one pt in fifth line. All pts were diagnosed with primary advanced disease. 2 of the pts (29%) had brain metastases and 1 pt (14 %) had ≥ 4 metastatic locations. 2 pts had use antibiotics in the month before and 1 pt used steroids. Best response to nivolumab per RECIST 1.1 criteria included 3 partial responses (43%), and 2 each (29%) had stable and progressive disease. Only 2 pts had no evidence of disease progression during > 2 years at last follow-up when the database was lock (April 2018). Five pts discontinued treatment due to disease progression.
After progression, 1 pt continued treatment with nivolumab, 1 pt started osimertinib (EGFR mutant previously treated with TKI and chemotherapy, and confirmed T790M+), and 3 pts started chemotherapy followed by retreatment with ICI. No patients discontinued due to adverse events.
8eea62084ca7e541d918e823422bd82e Conclusion
In our RWD experience, nivolumab resulted in a 2-years survival rate of 18% in previously treated advanced NSCLC patients. Clinical characteristics from real world patients do not predict for long term benefit of nivolumab. Immunological biomarkers are necessary to better select pts who will derive long-term benefit from immunotherapy.
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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
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P3.01-88 - Clinical and Molecular Analysis of Long-Term Survivors with Advanced Non-Small Cell Lung Cancer: A Multicenter Experience in Madrid (ID 12571)
12:00 - 13:30 | Author(s): Rosa Álvarez Álvarez
- Abstract
Background
Long survivors (LS) in non-small-cell lung cancer (NSCLC), defined as an overall survival (OS) greater than 2 years, are less than 10% in most series. Classical prognosis factors include stage, weight loss and ECOG, but there are other factors whose influence on the evolution of these patients is uncertain. Recently, different drugs targeted against EGFR, ALK and ROS 1 reach OS longer than 2 years in a limited number of patients (less than 20%). Immunotherapy in NSCLC has demonstrated very promising results with more LS compared to chemotherapy in first and second line setting. In this study, we have focused in the analysis of LS patients with advanced NSCLC EGFR wt (wild type) and ALK nt (non-translocated), defined as those with OS greater than 36 months, in 8 hospitals in Madrid.
a9ded1e5ce5d75814730bb4caaf49419 Method
In this serie, first of all, we will try to make a clinical, histopathological and immunological characterization collecting data from clinical reports according to a previously defined information. In a second step, we will carry out a genetic analysis of these patient samples comparing to an opposite extreme short survivors (SS) samples (OS less than 9 months) from same centers. We used a NGS method of RNA-seq technology with the idea of identify differentiating profiles of gene expression between the two opposite populations with a later confirmation by RT-PCR in the rest of the tissue samples and liquid biopsy.
4c3880bb027f159e801041b1021e88e8 Result
We have obtained a differential transcriptome expression between samples from 6 LS and 6 SS, resulting 13 overexpressed and 42 under-expressed genes in LS comparing to SS transcriptome expression. Some of the genes involved in this profile belong to different families and cellular pathways: Secretin receptor, Surfactant Protein, Trefoil Factor 1, Serpin Family, Ca bindings protein channel and Toll like Receptor family. A further confirmation of this profile is carrying on by RT-PCR in the rest of the samples and liquid biopsy from the rest of the patients included in the study.
8eea62084ca7e541d918e823422bd82e Conclusion
We present the first data from a genetic analysis of a LS population with NSCLC EGFR wt (wild type) and ALK nt (non-translocated), obtaining a differential RNA profile
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