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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      139P - Real-world immuno-oncology (IO) therapy treatment patterns and outcomes in patients with anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer (NSCLC) in the United States (ID 382)

      12:30 - 13:00  |  Author(s): Yu Yin

      • Abstract
      • Slides

      Background

      Cancer immunotherapies are new treatment options in advanced NSCLC. Evidence of IO therapy efficacy in tumors with activating mutations, such as ALK rearrangements, is lacking. This retrospective study describes the characteristics of ALK+ NSCLC patients treated with IO therapy and assesses treatment outcomes (time to treatment discontinuation, real-world progression-free survival [rwPFS], overall survival [OS]).

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      The Flatiron Health Electronic Health Record (EHR)−derived database (Jan 2011−Sep 2017) was used to identify patients with advanced ALK+ NSCLC who had received ≥1 ALK TKI and IO therapies (nivolumab, pembrolizumab, atezolizumab). Discontinuation of IO therapy was defined as switch to an ALK TKI or chemotherapy, death, or gap between last IO therapy administration and last follow-up date of > 120 days. rwPFS was estimated as the time from treatment initiation to progression (abstracted from clinician notes and radiology reports) or death. Time to discontinuation, rwPFS, and OS were analyzed using Kaplan-Meier methods.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Of 335 ALK+ NSCLC patients with follow-up between Jan 2015−Sep 2017, 32 (9.5%) patients were treated with IO therapy. Median age was 62.5 years, with 78.1% of patients diagnosed at stage IV, and 24 patients receiving nivolumab. Of the 32 IO treated patients, 15.6% received IO therapy before first ALK TKI, and 59.4% were treated with IO therapy after ≥2 ALK TKIs. Median (95% CI) time to discontinuation of IO therapy was 1.88 months (0.95 − 2.80), rwPFS was 2.17 months (1.18 − 2.93), and OS was 6.71 months (2.80−NE).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      We identified ALK+NSCLC patients who received IO therapy; most of whom were treated post ALK TKI. Time to discontinuation of IO therapy was short, and real-world effectiveness (rwPFS and OS) was limited. These results point to IO therapy’s relative futility in ALK+ NSCLC patients. Compared to IO therapy, several approved ALK inhibitors have shown better effectiveness in both first and later lines of therapy. However, the optimal sequencing of ALK inhibitors with other therapies, including chemotherapy and IO therapy, remains unclear.

      b651e8a99c4375feb982b7c2cad376e9 Editorial acknowledgement

      Jane Kondejewski, PhD of SNELL Medical Communication, Inc.

      934ce5ff971f1ab29e840a35e3ca96e9 Legal entity responsible for the study

      Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited.

      213f68309caaa4ccc14d5f99789640ad Funding

      Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited.

      682889d0a1d3b50267a69346a750433d Disclosure

      M.M. Lin: Employer: Millennium Pharmaceuticals, Inc. a wholly owned subsidiary of Takeda Pharmaceutical Company limited, which funded this study. X. Pan, Y. Yin, P. Hou, P. Baumann: Employee of Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited which funded this study. M. Jahanzeb: Research Grant: Lilly, Boehringer Ingelheim, Callisto; Research Grant, consultant: Millennium/Takeda, Novartis, Ipsen, Roche/ Genentech, Pfizer.

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