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Arsela Prelaj



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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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      150P - Characterization of patients with metastatic non-small cell lung cancer obtaining long term benefit from immunotherapy (ID 321)

      12:30 - 13:00  |  Author(s): Arsela Prelaj

      • Abstract
      • Slides

      Background

      The indications of Immunotherapy (IO) for metastatic Non Small Cell Lung Cancer (mNSCLC) are broadening. Although different studies have proved the efficacy of IO in this setting, only a minority of patients (pts) gains advantage from IO and predictive variables of Long Term Benefit (LTB) are incompletely understood.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      We retrospectively collected data about all consecutive mNSCLC pts treated with IO at Istituto Nazionale dei Tumori, Milan, Italy, from 04/2013 to 07/2017. We defined pts with LTB as those obtaining a Complete Response (CR), a Partial Response (PR) or a Stable Disease (SD) as best response from IO and maintaining it for ≥12 months (mos). Pts were defined to have a Short Term Benefit (STB) if they obtained a CR, a PR or a SD as best response but maintained it for <12 mos. Pts were defined as Progressors (P) If they obtained a progression as best response. Fisher’s test was used to compare variables. Multivariate analyses were performed with logistic regression. Survival was estimated with Kaplan-Meier method.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      One hundred forty-seven pts were identified. IO was an antiPD1 in 87 cases, an antiPDL1 in 52 cases, a combination antiPDL1/PD1 + antiCTLA4 in 7 cases, an antiCTLA4 in 1 case. First line IO was administered in 19 pts, II line IO in 63 pts, ≥III line IO in 64 pts. After a median follow up of 28.5 mos, 35 pts obtained LTB from IO. A higher proportion of LTB pts compared with controls (STB + P) showed CR/PR as first (12/35 vs 10/112, p = 0.0007) and best response (19/35 vs 14/112, p < 0.0001) to IO. More LTB pts than controls had a neutrophil/lymphocyte ratio<5 (p = 0.0378) and did not receive steroids (p = 0.0023), but only the evidence of a CR/PR during IO retained association to LTB at multivariate analyses (p = 0.0002). All other clinical and pathologic variables appeared unremarkable. A second analysis comparing pts with LTB and STB confirmed this result (odds ratio for CR/PR vs SD: 2.629, 95%CI: 1.051-6.579; p = 0.0427).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Objective response appears to be a central factor in predicting LTB from IO, irrespective of all other variables. If confirmed, this observation could help in identifying the pts with mNSCLC candidate to gain the highest advantage from IO.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

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