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Tim Breen
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P1.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 948)
- 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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P1.16-01 - Prognostic Variables Associated with Improved Outcomes in Stage III NSCLC Patients Treated with Consolidation Pembrolizumab (ID 14229)
16:45 - 18:00 | Author(s): Tim Breen
- Abstract
Background
HCRN LUN 14-179 is a phase II trial of consolidation pembrolizumab following concurrent chemoradiation for the treatment of patients with stage III NSCLC. Time to metastatic disease, PFS, and OS appear superior to historical controls of chemoradiation alone. Unfortunately, not all patients benefit from consolidation immunotherapy. We performed a univariate analysis evaluating variables associated with PFS, metastatic disease, and OS.
a9ded1e5ce5d75814730bb4caaf49419 Method
We conducted a retrospective analysis from patients enrolled on HCRN LUN14-179. Data collected included age, sex, stage, smoking status, PD-L1 status, >G2 vs <G1 adverse event, <G2 vs. >G3 pneumonitis, duration of pembrolizumab (<4 vs. >4 cycles), chemotherapy regimen, PS 0 vs 1, time to start pembrolizumab (<6 vs. >6 weeks from radiation), V20 (<20% vs. >20%), and total radiation dose. Univariate Cox regression was performed to determine the variables associated with 3 endpoints: time to metastatic disease/death; progression free survival; and overall survival.
4c3880bb027f159e801041b1021e88e8 Result
From April 2015 to December 2016, 93 patients were enrolled and 92 were included in the efficacy analysis (1 patient was ineligible). For time to metastatic disease or death, improved outcomes may be associated (p<0.1) with stage IIIA, non-squamous cell, >4 cycles of pembrolizumab, and V20< 20%. For PFS, improved outcomes (p<0.1) may be seen for females, stage IIIA, non-squamous histology, PD-L1 [-] tumors, >4 cycles of pembrolizumab, and V20< 20%. For OS, improved outcomes (p<0.1) may be seen for non-squamous histology, PD-L1 [-], >4 cycles of pembrolizumab, V20< 20%, and <G2 pneumonitis.
8eea62084ca7e541d918e823422bd82e Conclusion
Non-squamous NSCLC, PD-L1 [-] tumors, and V20 <20% may be associated with prolonged time to metastatic disease or death, PFS, and OS for patients with stage III NSCLC treated with chemoradiation followed by pembrolizumab.
6f8b794f3246b0c1e1780bb4d4d5dc53Variable
Alive without metastatic disease
Alive without progression
Alive
IIIA (n=55)
IIIB (n=37)
69% p=0.12
51%
56% p=0.21
41%
69% p=0.13
59%
Non-SCCA (n=51)
SCCA (n=41)
69% p=0.11
54%
55% p=0.21
44%
75% p=0.16
61%
PD-L1 [-] (n=11)
PD-L1 [+] (n=42)
82% p=0.13
57%
64% p=0.19
40%
91% p=0.07
62%
> 4 pembro (n=77)
< 4 pembro (n=15)
67% p=0.01
33%
55% p=0.04
27%
75% p=0.001
33%
V20 < 20% (n=19)
V20> 20% (n=59)
79% p=0.07
54%
63% p=0.08
39%
79% p=0.15
61%
G < 2 pneumonitis (n=87)
G > 3 pneumonitis (n=5)
63% p=0.28
40%
51% p=0.61
40%
70% p=0.16
40%
Female (n=33)
Male (n=59)
67% p=0.37
59%
67% p=0.11
59%
73% p=0.51
66%
