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Poster Session (ID 8)
- Event: ACLC 2018
- Type: Poster Session
- Presentations: 1
- Coordinates: 11/07/2018, 00:00 - 00:00, Poster Hall
P023 - Factors associated with administration of subsequent cytotoxic chemotherapy after nivolumab in patients with advanced NSCLC (ID 164)
00:00 - 00:00 | Author(s): Y. Fujiwara
Immune checkpoint inhibitors, including nivolumab, have shown a promising clinical efficacy in patients with advanced non-small cell lung cancer (NSCLC). Based on the characteristic pattern of response and progression, however, there is substantial clinical concern about the timing of switching treatment after progressive disease in patients receiving nivolumab treatment.
We conducted a consecutive retrospective analysis of patients with advanced NSCLC treated with nivolumab as a second-line treatment at the National Cancer Center Hospital from December 2015 to November 2017. Clinical information including age, sex, performance status (PS), histology, and progressive disease (PD) situation at the point of the last dose of nivolumab were evaluated. We defined the PD situation as follows: continuation of nivolumab after worsening of imaging findings (beyond PD); PD after ?2 cycles of nivolumab without beyond PD (Early PD), and PD after 3? cycles of nivolumab without beyond PD as (Late PD).
A total of 213 patients received nivolumab; 109 of these patients received nivolumab as a second-line treatment. Finally, 105 patients (78 men, 27 women) without EGFR or ALK driver oncogene mutations were included in this analysis. The patients' characteristics were as follows: male/female, 78/27 patients; median age (range), 63 (34-83) years; PS 0/1/2/3/4, 19/57/18/6/5 patients; and non-squamous/squamous histology, 77/28 patients. Four patients were treated beyond PD. The median number of nivolumab treatment cycles was 6, the objective response rate was 16%, and the median progression-free survival was 3.9 months (95% confidence interval: 2.5-6.0 months ). Among the 90 patients with disease progression, 42 patients (47%) received chemotherapy after nivolumab treatment. Among the patients with disease progression who did not receive chemotherapy after nivolumab treatment (48 patients, 53%), the main reasons for non-administration were a worsening of the patient