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S. Cai

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    Poster Session (ID 8)

    • Event: ACLC 2018
    • Type: Poster Session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 11/07/2018, 00:00 - 00:00, Poster Hall
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      P104 - Anti-PD-1 Combination Therapy in Second or Later Lines in (ID 114)

      00:00 - 00:00  |  Author(s): S. Cai

      • Abstract

      Recent studies have indicated that anti-PD-1/PD-L1 antibodies combined with chemotherapy and/or bevacizumab could be a tolerable and effective option for patients with non-squamous NSCLC in the first line treatment. However, in second-line setting, overall response rate (ORR) of PD-1/PD-L1 checkpoint blockades used as single agent for advanced NSCLC patients who experience progression on or after platinum-based chemotherapy is limited. Therefore, we retrospectively assessed the safety and efficacy of anti-PD-1 combined with chemotherapy and/or bevacizumab as second-line treatment or beyond in patients with advanced NSCLC patients.

      92 Patients of stage IIIB or IV NSCLC treated with anti-PD-1 therapy in the Cancer Center of the PLA General Hospital from January 2015 to September 2017were screened for eligibility. First-line treatment were excluded. Regimens were anti-PD-1 antibody as monotherapy or in combination with chemotherapy and/or bevacizumab. The primary endpoint was progression-free survival (PFS). Secondary endpoints were overall response rate (ORR), disease control rate (DCR) and safety profile.

      A total of 55 patients were enrolled for the study, 33 patients were received anti-PD-1 antibody monotherapy, 22 patients were received anti-PD-1 antibody plus chemotherapy and/or bevacizumab. The PFS of anti-PD-1 combination therapy was longer than that of monotherapy group (median, 7.5 vs 3.3 months, HR, 0.349, 95% CI, 0.17-0.73, P <0.0001). 7 of 22 patients (31.8%) in the combination groups achieved an objective response compared with 3 of 30 patients (10.0%) in the PD-1 antibody monotherapy group (P=0.075). 21 of 22 (95.5%) patients in the combination therapy achieved a disease control compared with 14 of 30 patients (46.7%) in the monotherapy group (P=0.000). The incidence of grade 3/4 treatment-related adverse events were 2 of 33 patients (6.1%) in monotherapy group and 5 of 22 patients (22.7%) in combination group. No treatment-related mortality was observed.

      Preliminary data indicated that PD-1 based combination therapy as second line treatment and beyond exhibited a promising safety profile. More importantly, PD-1 antibody plus chemotherapy and/or bevacizumab could have a longer PFS and a higher ORR and DCR. Given the relative small sample size and limitations of retrospective observational study, the strategy needs further exploration.