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Elizabeth Dudnik



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    OA11 - Decomplexifying Molecular Targets, Immunotherapy and Treatment Settings in the Real World (ID 137)

    • Event: WCLC 2019
    • Type: Oral Session
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 1
    • Now Available
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      OA11.06 - Alternative Nivolumab (N) Duration and Scheduling in Advanced Non-Small Cell Lung Cancer (aNSCLC): Real-Life Data (Now Available) (ID 1921)

      14:00 - 15:30  |  Presenting Author(s): Elizabeth Dudnik

      • Abstract
      • Presentation
      • Slides

      Background

      Little is known regarding the optimal scheduling and treatment (Tx) duration of N in aNSCLC. Stopping N after 1 year of Tx negatively affects outcomes.

      Method

      45 consecutive aNSCLC patients (pts) receiving N for ≥2 years (y) were identified in the electronic databases of 4 Israeli cancer centers. These were divided into Groups A (N continued for >2y at a dose 3mg/kg q2w/240mg q2w; n-21), B (N continued for >2y at a dose 3mg/kg q3w-q8w/480mg q4w; n-17), and C (N stopped at 2y for reason other than progressive disease or intolerable toxicity; n-7). PFS (RECIST 1.1) and safety since 2y after N initiation were assessed.

      Result

      Baseline, treatment characteristics and outcomes are presented in the Table and the Picture. Allocation to Group B and C was associated with HR for PFS-2.4 (95%CI, 0.3-18.8, p-0.4) and HR for PFS-3.3 (95%CI, 0.3-30.9, p-0.3), respectively. After 2y since N initiation, new N-related toxicity developed in 24%, 18%, and 28% of pts in Groups A, B, and C, respectively (p-NS).

      table wclc.jpgpicture wclc.jpg

      Conclusion

      A trend for worse outcomes was observed with alternative N scheduling/N quitting 2y after initiation. So far, continuing N at a standard dose until disease progression/ intolerable toxicity remains the standard treatment option.

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    P2.06 - Mesothelioma (ID 170)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Mesothelioma
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.06-14 - BAP1 Mutant Malignant Pleural Mesothelioma (MPM): Outcomes with Chemotherapy, ICPi and PARPi (Now Available) (ID 1244)

      10:15 - 18:15  |  Presenting Author(s): Elizabeth Dudnik

      • Abstract
      • Slides

      Background

      Little is known regarding the outcomes of systemic treatments (Tx) in BAP1 altered MPM.

      Method

      45 patients (pts) with advanced MPM (Group A: 8 MPM with a BAP1 inactivating mutation/copy number loss (FoundationOne CDx/TEMPUSxT), selected from the electronic databases (eD) of 4 Israeli cancer centers (ICC); Group B: 37 consecutive (years 2016-2018) MPM without a BAP1 alteration/not tested, selected from the eD of 2 ICC) were analyzed for ORR, PFS (mRECIST 1.1) and OS with platinum/pemetrexed+/-bevacizumab/nintedanib (CT, n-28), immune check-point inhibitors (ICPi, n-16) and poly (ADP-ribose) polymerase inhibitors (PARPi, n-4). OS since diagnosis (OSDx) was assessed.

      Result

      Pt and Tx characteristics are presented in the Table. There were no differences in ORR, mPFS or mOS with CT between the Groups: ORR-50% in both Groups, mPFS-9.1mo (95%CI, 1.2-16.1) vs 9.2mo (95%CI, 2.9-17.8) (log-rank-0.01, p-0.9), mOS-NR (95%CI, 6.6-NR) vs 18.5mo (95%CI, 5.4-46.3) (log-rank-1.1, p-0.3), in Groups A and B, respectively. There were no differences in ORR, mPFS or mOS with ICPi between the Groups: ORR- 33% vs 50% (p>0.5), mPFS-2.5mo (95%CI, 1.4-3.7) vs 3.0mo (95%CI, 0.3-10.5) (log-rank-0.5, p-0.4), mOS-NR (95%CI, 4.0-NR) vs 5.8mo (95%CI, 0.3-13.2) (log-rank-0.1, p-0.7), in Groups A and B, respectively. In Group A, no responses were seen with PARPi; PFS with PARPi was 1.8mo (95%CI, 1.8-1.9). OSDx was NR (95%CI, 9.7-NR) vs 19.5mo (95%CI, 9.7-82.2) in Groups A and B, respectively (log-rank-1.6, p-0.2). In the univariate analysis, sex (p-0.04), histology (p-0.002), ECOG PS (p-0.03), but not BAP1 mutation (p-0.3) correlated with OSDx.wclc table.jpg

      Conclusion

      Outcomes with CT and ICPi in BAP1 mutant MPM are similar to non-selected MPM. No responses were seen so far with PARPi. According to our data, presence of BAP1 mutation does not affect OS. Additional follow-up is needed.

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