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Alfredo Addeo



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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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      153P - Chemotherapy with immune-checkpoint inhibitors in first-line treatment metastatic NSCLC patients: Systematic review and literature-based meta-analysis (ID 179)

      12:30 - 13:00  |  Presenting Author(s): Alfredo Addeo

      • Abstract
      • Slides

      Background

      Checkpoint inhibitors plus platinum-based chemotherapy have shown superiority compared to chemotherapy alone as first-line therapy in advanced non–small cell lung carcinoma (NSCLC), but little is known about the real benefit within the different PDL1 expression subgroups. Our aim was to estimate the relative benefit in term of Overall Survival (OS) and Progression-free Survival (PFS) of checkpoint inhibitors plus chemotherapy versus chemotherapy alone, overall and in subgroups defined by PDL1 expression.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      This meta-analysis searched PubMed and checked references of articles to identify trials that combined checkpoint with chemotherapy versus chemotherapy in the first-line setting. For each trial included in this study, the trial name, year of publication or conference presentation, patients’ clinic-pathological characteristics, type of chemotherapy, type of checkpoint inhibitor and PDL1 expression were extracted. Data collection took place from October 1th to October 24th, 2018. A random-effects model was applied.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Eight trials with advanced NSCLC were included in this meta-analysis. Checkpoint inhibitors plus chemotherapy were associated with prolonged OS, compared with chemotherapy in the ITT population (HR, 0.61; 95% CI, 0.61-0.66; P<.000001). OS was prolonged in the PDL1 0% group (HR, 0.78; 95% CI, 0.67-0.90; P<.0007) and in the PDL1 high (HR, 0.61; 95% CI, 0.48-0.78; P<.00001) but not in the PDL1 low (HR, 0.77; 95% CI, 0.55-0.107; P < 0.12). Chemotherapy plus pembrolizumab showed OS benefit (HR, 0.56; 95% CI, 0.40-0.78; P<.00007)in low PD-L1 low, unlike atezolizumab backbone trials (HR, 0.92; 95% CI, 0.62-1.37; P < 0.69). Checkpoint inhibitors plus chemotherapy were associated with prolonged PFS in the ITT (HR, 0.61; 95% CI, 0.56-0.66; P < 0.00001) across PDL1 subgroups.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Checkpoint inhibitors plus chemotherapy compared to chemotherapy, are associated with prolonged OS and PFS in first-line therapy in NSCLC. In low PDL1 subgroup the benefit was statistically significant only in the pembrolizumab backbone trials. The findings of this meta-analysis could assist in the design and interpretation of future trials and in economic analyses.

      b651e8a99c4375feb982b7c2cad376e9 Editorial acknowledgement

      none

      934ce5ff971f1ab29e840a35e3ca96e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      A. Addeo: Consulting role: MSD, Roche, Pfizer, Astrazeneca, BMS, Boehringer Ingelheim; Research grant: Boehringer Ingelheim; Travel grant: Roche, MSD. M. Di Maio: Honoraria for lectures in meeting, participation in Advisory boards: Astellas, Janssen. All other authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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