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Yingying Pan

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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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      171P - Previous exposure to bevacizumab indicated inferior benefits from PD-1/PD-L1 inhibitors in nonsquamous NSCLC (ID 344)

      12:30 - 13:00  |  Author(s): Yingying Pan

      • Abstract


      Bevacizumab is known to enhance the effects of immunotherapy. The landmark IMPOWER150 has demonstrated that the addition of atezolizumab to bevacizumab plus chemotherapy significantly improved survival outcomes among patients with metastatic nonsquamous NSCLC. However, the impact of previous use of bevacizumab on the efficacy of PD-1/PD-L1 inhibitors remained unclear.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      Between Oct 2016 to Sep 2019, 113 patients who were treated with PD-1/PD-L1 inhibitors either as a standard of care or on a clinical trial at Shanghai Pulmonary Hospital were identified. Patients who had prior exposure to immunotherapeutic agents, or death within 4 weeks from the first dose of ICIs treatment were excluded from the analysis. The information regarding previous exposure to bevacizumab was reviewed in electronic medical record.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      The median age of enrolled patients was 63 years (range, 29 to 82). Regarding histology, 59.2% (67/113) had nonsquamous NSCLC and 40.8% (46/113) had squamous cell carcinoma. Overall, 16 patients (14.2%) previously received bevacizumab therapy, all of whom had nonsquamous NSCLC. Interestingly, patients who were previous exposure to bevacizumab had shorter PFS than those who were not (1.9 versus 4.3 months, P = 0.017). We then divided patients into 3 groups: arm 1 (16 patients, previous exposure to bevacizumab), arm 2 (51 patients, nonsquamous NSCLC who were not previous exposure to bevacizumab), arm 3 (46 patients, squamous cell carcinoma). The PFS was significantly different between arm 1 and arm 2 (1.9 versus 4.3 months, P = 0.023) or arm 3 (1.9 versus 4.2 months, P = 0.045), but not arm 2 and arm 3 (4.3 versus 4.2 months, P = 0.736). Patients in arm 1 also had inferior ORR (14.3% versus 29.4% versus 29.5%, P = 0.342) and DCR (42.9% versus 70.6% versus 68.2%, P = 0.05) compared with arm 2 and arm 3. Multivariate analysis identified previous exposure to bevacizumab as being independently associated with poorer PFS (HR = 1.9, 95%CI, 1.01-3.59, P = 0.048).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Previous use of bevacizumab indicated inferior benefits from PD-1/PD-L1 inhibitors in nonsquamous NSCLC.

      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.