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Martin Faehling

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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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      163P - Immuno-oncological treatment and tumor load in non-small cell lung cancer (NSCLC): Case-control analysis of overall survival (OS) in routine clinical practice (ID 476)

      12:30 - 13:00  |  Presenting Author(s): Martin Faehling

      • Abstract


      Immuno-oncological (IO) therapies such as PD-1 and PD-L1-antibodies have been introduced in the treatment of advanced NSCLC since 2015 based on randomized trials showing unprecedented advantages in OS with hazard ratios (HR) often between 0.5 and 0.6. The impact of these treatments on survival in routine clinical practice and the role of tumor load have not been studied.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      1334 patients diagnosed with NSCLC in our certified lung-cancer center from 2006 – September 2018 were studied. OS of immuno-oncologically treated patients (“IO-patients”) who received treatment with a PD-1 antibody (nivolumab [n = 76] or pembrolizumab [n = 51]) or a PD-L1-antibody (atezolizumab [n = 4] or durvalumab [n = 12]) was compared to historic controls treated in our center before availability of IO-treatment using case-control analysis. IO-patients and historic controls were individually matched for stage, performance state, histology, smoking history, gender, age, and initial treatment mode (palliative vs. curative). Matching was performed blinded to patient number, treatment, and survival. The study was approved by the local ethics committee (Landesärztekammer Baden-Württemberg F-2017-004).

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      IO-patients had significantly longer OS than historic controls (21.8 vs. 10.7 months, HR 0,55, CI 0.40 - 0.75, p = 0.0002). The benefit was more pronounced in patients with lower tumor stage (HR 0.364 [stage III], 0.407 [IVA], 0.605 [IVB]) or smaller tumor size (HR 0.32 [RECIST < 65], 0.38 [RECIST 65-100], 0.56 [RECIST 101-145], 0.86 [RECIST > 145]).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      IO-patients in routine clinical practice showed significant benefit in OS with hazard ratios comparable to that reported in phase III trials. The benefit was greater in patients with lower tumor load.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      M. Faehling: Advisory boards: AstraZenenca, BMS, MSD, Roche. All other authors have declared no conflicts of interest.