Virtual Library
Start Your Search
Martin Frueh
Author of
-
+
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
-
+
157P - Prognostic impact of the use of antibiotics in patients with advanced non-small cell lung cancer (NSCLC) receiving PD-(L)1 targeting monoclonal antibodies (ID 242)
12:30 - 13:00 | Author(s): Martin Frueh
- Abstract
Background
Anti-PD-(L)1 monoclonal antibodies (mAb) have changed the therapeutic landscape in patients with advanced NSCLC, still 35-40% of these patients derive no benefit from anti-PD-(L)1 mAb. Antibiotics alter gut microbiota diversity and composition, and may affects antitumor immune responses following immune checkpoint inhibitors (ICI) in NSCLC.
a9ded1e5ce5d75814730bb4caaf49419 Methods
We retrospectively included 218 patients with advanced NSCLC receiving anti-PD-(L)1 mAb. Overall survival (OS) (primary endpoint), progression free survival (PFS) and radiological response was compared between patients who received antibiotics within 2 months prior to the start of immunotherapy (ATB+) and patients who did not (ATB-). Assuming a rate of antibiotic comedication of 20% of all patients included, the study had a power of 70% to detect a 35% OS improvement in ATB- patients.
20c51b5f4e9aeb5334c90ff072e6f928 Results
Patients are well balanced with the exception of PD-L1 immunohistochemical expression that was more frequent in ATB+ compared to ATB- (30% vs. 19%, P = 0.05). ATB+ compared to ATB- was associated with a significantly shorter OS (median OS, 10.6 vs 29.9 months, HR 2.7, 95% CI 1.7-4.1, P < 0.001) and shorter PFS (median PFS 1.4 vs 5.8 months, HR 2.2, 95% CI 1.5-3.4, P < 0.001). In the adjusted model for OS, the following 4 parameters retained a statistically significant prognostic value : ATB+ vs. ATB- (HR 2.8, 95% CI 1.7-4.5, P < 0.001), ECOG performance score >1 vs. 0-1 (HR 2.3, 95% CI 1.4-3.7, P = 0.001), squamous-cell vs. Non squamous-cell histology (HR 2.1, 95% CI 1.4-3.2, P < 0.001) and no prior radiotherapy vs. prior radiotherapy (HR 1.7, 95% CI 1.2-2.6, P = 0.006). ATB+ compared to ATB- was significantly associated with an increased risk of progressive disease as best radiological response (73% vs 41%, P = 0.002).
fd69c5cf902969e6fb71d043085ddee6 Conclusions
Antibiotic treatment is associated with a reduced clinical benefit from therapy with anti-PD-(L)1 mAb. The negative prognostic value of antibiotics was independent from known prognostic factors. However, further investigation is required on the mechanism behind this observation, with emphasis on the role of the gut microbiota composition in the context of anticancer immune response.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
M. Joerger.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25 -
+
179P - Treatment (tx) characteristics of patients (pts) with locally advanced or metastatic non-small cell lung cancer (NSCLC) receiving atezolizumab (atezo) monotherapy in US clinical practice (ID 227)
12:30 - 13:00 | Presenting Author(s): Martin Frueh
- Abstract
Background
In the randomised Ph III OAK study, atezo (anti–PD-L1) significantly improved survival vs docetaxel, regardless of PD-L1 levels, and was approved by the FDA and EMA as 2L+ tx for advanced NSCLC. Given limited real-world data (RWD) on atezo in clinical practice, we describe here tx and characteristics of pts receiving atezo in clinical practice.
a9ded1e5ce5d75814730bb4caaf49419 Methods
Pts diagnosed with advanced NSCLC on or after Jan 1, 2011, and who initiated 2L+ atezo before Jul 1, 2017, were identified from the Flatiron Health database of electronic health records from US-based hospitals and community practices. Time-on-treatment (TOT) was defined as time from first to last atezo dose, plus 1 cycle. Median TOT was calculated using the Kaplan-Meier methods. Data from the OAK registrational trial (NCT02008227) are provided.
20c51b5f4e9aeb5334c90ff072e6f928 Results
122 pts met selection criteria (Table). 105 pts (86%) had 2L+ atezo without prior anti–PD-1 tx, while 17 pts (14%) had prior anti–PD-1 tx. Median TOT was 3.9 mo (95% CI: 2.9, 4.9), similar to OAK. A median of 4 cycles was administered for both non-squamous (IQR 1-22) and squamous (IQR 1-17) histology. Progression was the most common reason for atezo discontinuation.
fd69c5cf902969e6fb71d043085ddee6 Conclusions
TOT with atezo in the US RW setting was similar to the OAK clinical trial setting, although pts treated in RW were older and 22% had ≥ 3 lines of previous therapy.
b651e8a99c4375feb982b7c2cad376e9 Editorial acknowledgement
Medical writing assistance for this abstract was provided by Steffen Biechele, PhD, of Health Interactions and funded by F. Hoffmann-La Roche, Ltd.
934ce5ff971f1ab29e840a35e3ca96e9 Legal entity responsible for the study
F. Hoffmann-La Roche, Ltd.
213f68309caaa4ccc14d5f99789640ad Funding
F. Hoffmann-La Roche, Ltd.
682889d0a1d3b50267a69346a750433d Disclosure
M. Frueh: Consulting/advisory: BMS, MSD, AZ, BI, Roche; Research funding: MSD. O.E. Rahma: Advisory board: Celgene, Leerink, PRMA Couns., Outcomes4me, Puretech; Consulting: Alcimed SAS, GFK, Merck, Five Prime, Defined Health Honorarium: Merck, Clinical Care Option, Mi Bioresearch, Alaunusglobal; Other (study/editorial support): Roche. R.K. Pachynski: Grants/research support: Ferring, Janssen; Consultant: AZ, BMS, EMD Serono, Exelixis, Dendreon, Jounce, Pfizer; Speakers: AZ, GNE/Roche, Dendreon, Genomic Health, Sanofi, Merck; Other (support of parent study and funding of editorial support): Roche. J. Mazieres: Financial relationship: Roche, BMS, MSD, AstraZeneca, Pfizer, Novartis: consulting fees; Contracted research: Roche, BMS. J. Goldschmidt Jr.: Consulting/advisory role/honorarium: Amgen; Speakers bureau: BMS, Celgene; Support of parent study, funding of editorial support: Roche. T.G.N. Ton: Full time employee with self-managed stock: Genentech/Roche. S.K. Mhatre: Genentech, Inc./F. Hoffmann-La Roche: full time employee F. Hoffmann-La Roche: Stock shareholder (self managed) C-Y. Chuo: Full time employee, stock, support of parent study, funding of editorial support: Roche/Genentech. J. Martinalbo, J. Davies: Full time employee: F. Hoffmann-La Roche. R. Juergens: Honoraria: Amgen, AZ, BI, BMS, Lilly, Merck Sharp & Dohme, Roche Canada; Consulting or advisory role: Amgen, AZ, BI, BMS, Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Roche Canada; Research funding: AZ/MedImmune, BMS, Merck Sharp & Dohme, Novartis.
cffcb1a185b2d7d5c44e9dc785b6bb25
