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Christos Chouaid



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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 2
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      165P - Clinical benefit of anti PD-1/PD-L1 plus chemotherapy versus chemotherapy alone in first-line treatment in advanced non-small cell lung cancer: A meta-analysis (ID 383)

      12:30 - 13:00  |  Author(s): Christos Chouaid

      • Abstract
      • Slides

      Background

      First-line therapy for advanced non–small-cell lung cancer (NSCLC) that lacks targetable mutations is platinum-based chemotherapy. Combination of anti-PD-1/PD-L1 to chemotherapy (CT) offers a new therapeutic option for this population.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      We performed a meta-analysis of randomized trials that compared PD-1/PD-L1 inhibitor plus CT with CT alone in first line of treatment for advanced NSCLC. The outcomes included overall survival (OS), progression-free survival (PFS) and objective response rate (ORR). A fixed-effect or random-effects model was adopted depending on between-study heterogeneity.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      The eight eligible studies included 4401 patients (3097 males, mostly smokers (81%), median age 64 years), with 3037 nonsquamous (69 %) and 1330 squamous tumours (30%). One study evaluated nivolumab + CT (CheckMate 227), four studies evaluated atezolizumab + CT (IMpower 130,131,132 and 150), and three studies pembrolizumab + CT (Keynote 021, 189 and 407). The combination PD-1/PD-L1 inhibitor + CT was significantly associated with improvement of OS (hazards ratio [HR], 0.72; 95% CI 0.61–0.85; p < 0.0001), PFS (HR, 0.63; 95% CI 0.58–0.68; p < 0.0001) and ORR (relative ratio [RR], 2.08; 95% CI 1.69–2.55; p < 0.0001), irrespective of PD-L1 expression level. For patients with low (<1%) or undetectable PD-L1 expression, OS benefit was statistically significant (HR, 0.75; 95% CI 0.63-0.89; p < 0.0008).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      The combination of PD-1/PD-L1 inhibitor to chemotherapy, compared with chemotherapy alone, is associated with significantly improved OS, PFS, and ORR in first-line therapy in NSCLC. This strategy appears as a new standard of care for patients with untreated NSCLC, including for those with low or undetectable PD-L1 expression.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      APHP.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

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      90P - Real-world treatment patterns, clinical practice and outcomes for locally advanced, non resectable, non-small cell lung cancer from the French ESME Lung database (ID 525)

      12:30 - 13:00  |  Author(s): Christos Chouaid

      • Abstract

      Background

      Approximately 30% of patients (pts) with non-small-cell lung cancer (NSCLC) are diagnosed with locally advanced disease, which is often unresectable. The historical standard of care (SoC) has been platinum-based chemoradiotherapy (CRT), based on data from clinical trials conducted in selected populations. As immunotherapy is being integrated in the treatment strategy, real-world evidence aiming at understanding the current management of those patients is missing.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      This study is an analysis of the Epidemio-Strategy and Medical Economics (ESME) Lung Data Platform, a multi-center real-life database using a retrospective data collection process. This database compiles data from patient’s Electronic medical records (EMR), inpatient hospitalisation records and Pharmacy records. 8514 pts from 20 centres with lung cancer treated between January 1st, 2015 and December 31st, 2016, were included.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      822 pts with unresectable locally advanced NSCLC - 69% male, median age 65y, 61% ECOG PS0-1, 60% non-squamous histology - were included in the analysis. Treatment was initiated in 736 pts (analysis population): 39% concurrent CRT (cCRT), 17% sequential CRT (sCRT), 26% chemotherapy (CT) alone, 16% radiotherapy (RT) alone and 2% other therapy. For cCRT, 95% of pts received induction chemotherapy before the concurrent phase, based on taxanes (32% of pts), vinorelbine (42% of pts), or pemetrexed (16% of pts); 35% of patients received consolidation chemotherapy. For sCRT, preferred platinum doublet chemotherapy regimens were based on taxanes (39% of pts), vinorelbine (26% of pts), or pemetrexed (17% of pts). Radiotherapy was delivered to a total dose of 60-66 Gy for 84% (cCRT) and 71% (sCRT). After a median follow-up of 17 months, progression rate was 62%; progression occurred in the thorax, the brain, or at other sites in 42%, 19% and 38% of pts, respectively. Median PFS was 8.0 months (m) for the analysis population, 9.3 m (cCRT) and 11.6 m (sCRT). 24-month OS rate was 51%, 60%, and 52%, respectively.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Real world data support the use of CRT in locally advanced NSCLC, with similar outcomes than in landmark clinical trials.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      UNICANCER.

      213f68309caaa4ccc14d5f99789640ad Funding

      AstraZeneca.

      682889d0a1d3b50267a69346a750433d Disclosure

      N. Girard: Fees for attending scientific meetings, speaking, organizing research or consulting: AstraZeneca, Boehringer Ingelheim, Roche, SBMS, MSD, Lilly, Novartis, Pfizer, Amgen. M. Pérol, R. Gervais: Symposium, advisory board: AstraZeneca. C. Audigier Valette: Consultancy, Advisory board membership: AstraZeneca, Pierre Fabre. C. Chouaid: Fees for attending scientific meetings, speaking, organizing research or consulting: AstraZeneca, Boehringer Ingelheim, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Bayer, Pfizer, Takeda, Amgen. All other authors have declared no conflicts of interest.

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