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Arantzazu Barquín García



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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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      155P - Association of immune-related adverse events (irAEs) and immunotherapy (IT) benefit in advanced non-small cell lung cancer (NSCLC) (ID 577)

      12:30 - 13:00  |  Author(s): Arantzazu Barquín García

      • Abstract
      • Slides

      Background

      IT has improved outcomes in advanced NSCLC. However, this therapy can yield significant toxicity secondary to immune activation. Several retrospective studies have reported a direct relationship between IT efficacy and the development of irAEs, in Response Rate (RR) and survival.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      We retrospective reviewed our experience with anti-PD1/anti-PDL1 as single agent in advanced NSCLC patients treated between February 2014 and August 2018. Patient and tumor features, irAEs, concomitant and subsequent treatments were collected. Stata 14.1 was used for the analysis.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      98 patients were included. Mean age was 62 years (41-85). 73.5% were men. 73.5% had > 30 smoked pack-years. 64.3% were adenocarcinoma, of which 41% showed KRAS mutation; PDL1 was known in 50% of patients (11.2% <1%, 13.3% 1-49%, 25.5% >50%). IT was administered mainly as a second line (61%) and third or later (24.5%). Most employed drug was nivolumab (52%). RR was 33% (partial response 28%, complete response 5%). Disease control rate (DCR) was 55% and progression rate 34% as better response, 67% at the moment of the analysis. irAEs were reported in 30.6%. The table summarizes irAEs. We found a significant association between irAEs and RR (OR 3.71 p 0.005 IC 1.49 - 9.23) and DCR (OR 5.06 p 0.002 IC 1.84 - 13.98). An impact of irAEs in progression-free survival (PFS) (1.7 vs 7.7 months (m) HR 0.44 p 0.002 IC 0.26 - 0.73) and overall survival (OS) (6.1 vs 15.7 m HR 0.53, p 0.026, IC 0.31- 0.93) was found too. Most of the patients requiring steroid therapy during IT was due to an irAE. There was not detrimental effect of steroids in RR (OR 3.17 p 0.01 IC 1.3 - 7.76), DCR (OR 6.17 p 0.000 IC 2.33 - 16.34), PFS (1.6 vs 6 m HR 0.36 p 0.000 IC 0.22 - 0.62) or OS (6.2 vs 13.3 m HR 0.61 p 0.057 IC 0.36 - 1.01).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      The development of irAEs appears to be associated with efficacy of IT in our retrospective review. The use of steroids during IT had no negative impact in RR, DCR or survival. Still, we need prospective studies in order to confirm this hypothesis.

      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.

      cffcb1a185b2d7d5c44e9dc785b6bb25

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.

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      169P_PR - Benefit of immunotherapy (IT) in advanced non-small cell lung cancer (NSCLC) in elderly patients (EP) (ID 582)

      12:30 - 13:00  |  Author(s): Arantzazu Barquín García

      • Abstract
      • Slides

      Background

      Despite EP (aged ≥70 years) represent the majority of patients with advanced NSCLC, the efficacy and toxicity rates of IT remain poorly described, as they are under-represented in clinical trials. Furthermore, the age-related decline in the immune system might affect efficacy of IT.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      We retrospectively reviewed advanced NSCLC patients treated with IT (antiPD-1, anti-PD-L1) monotherapy as first, second and subsequent-line settings, between 2014 and 2018 in our hospital. Patient and tumor features, irAEs, concomitant and subsequent treatments were collected. Stata 14.1 was used for the analysis.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      98 patients were included. Mean age was 62 years (41-85). 73.5% were men. 73.5% had >30 smoked pack-years (py), 64.3% were adenocarcinoma (ADC), of which 41% were KRAS mutated; and 25.5% were squamous (SCC). PDL1 was known in a 50% of patients (11% <1%, 13% 1-49%, 25% >50%). IT was administered mainly as a second line (61%) and third or later (24.5%). Most employed drug was nivolumab (52%) (Table). Response Rate (RR) was 32.7% (partial response 28%, complete response 5%). Disease control rate (DCR) was 55%. Overall Survival (OS) was significantly lower in EP compared to patients aged <70 years (5.5 vs 13 months (m) HR 3.86; IC 2.073- 7.214; P < 0.0001). Progression-free survival (PFS) was significantly worse for EP than for younger patients (1.8 vs 3.6m, HR 2.1; IC 1.181 - 3.744; P = 0.012). Regarding toxicity, 30.6% irAEs were reported. There were no statistically significant differences in terms of irAEs between EP and younger patients (P = 0.535). The development of irAEs was associated with better PFS in younger patients (13.3 vs 5.5m, HR 0.45; IC 0.244 - 0.840; P = 0.012) without significant impact on OS.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Our results suggest that EP could have worse survival outcomes than younger patients, without differences in terms of toxicity, but prospective trials are needed to confirm this hypothesis.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      Elena Corral de la Fuente.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.