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Laia Vilà
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EP1.04 - Immuno-oncology (ID 194)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.04-25 - Increased PD-L1 Expression in MET Amplified (AMP) Advanced Non Small Cell Lung Cancer (NSCLC) Patients (P) (ID 2764)
08:00 - 18:00 | Author(s): Laia Vilà
- Abstract
Background
MET amp has been reported in a subset of NSCLC p and treatment with crizotinib has proved clinical activity in cases of MET exon 14 alterations and MET amp.. Recently, immunotherapy has emerged as a new approach to treat NSCLC. The development and success of programmed cell death 1 (PD-1)/program death-ligand 1 (PD-L1) checkpoint inhibitors has been correlated with PD-L1 status, particularly in NSCLC p whose tumors express high PD-L1 levels by tumor proportion score (TPS) ⩾ 50%. In this study we have reviewed the PD-L1 status in a cohort of advanced NSCLC p with a METamp.
Method
PDL1 expression has been evaluated in a retrospective cohort of NSCLC p with MET amp and wild type for EGFR, KRAS, BRAF mutations and ALK and ROS1 rearrangements. Overall Survival (OS) was evaluated with Kaplan-Meier curves and groups were compared using log-rank test. Clinical and tumor characteristics, as well as treatment details, were evaluated. MET amp was analyzed by FISH, while PD-L1 status was assessed by immunochemistry by SP 263. antiboby
Result
A total of 50 p were included, 15 p has high or intermediate Met amp and 35 p had low or negative Met amp. Median age were 66 years old. 39 (78%) p were male, 43 (86%) p were smokers or former smokers, 37 p (74%) were ECOG PS 0-1, 37 p (74%) were stage IV. PD-L1 were negative ( < 1%) in 21 p (42%), positive ( >1%) in 26 p ( 52%). PD-L1 highly positive in 18 p ( 36%). Statistically significant more p had PD-L1 positive ( TPS > 1%) in high or intermediate Met amp p versus low or negative ( 92.9% vs 39.4%; p 0.001). And high or intermediate Met amp p had PD-L1 high expression ( TPS > 50%) than negative or low Met amp p ( 64.3% vs 27.3%; p 0.020). No differences in PD-L1 expression was observed by gender, ECOG PS or smoking status. Median OS was 16.367 m (2.295-30.438). No differences in OS were seen by PD-L1 expression or Met amp status.
Conclusion
PD-L1 expression in NSCLC p is positively correlated with MET amp, especially in p with PD-L1 > 50%. Our data suggests that MET amp may play a direct role in up-regulating PD-L1 expression in NSCLC p. Additionally, combination therapy targeting MET and checkpoint inhibition should be considered as a potential therapeutic strategy for NSCLC p with high and intemediate MET amp.
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P1.01 - Advanced NSCLC (ID 158)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.01-93 - Metastases Sites as a Prognostic Factor in a Real-World Multicenter Cohort Study of Spanish ALK-Positive NSCLC Patients (p) (ID 1377)
09:45 - 18:00 | Author(s): Laia Vilà
- Abstract
Background
ALK gene rearrangements are detected in 3-7% of Non-Small-Cell-Lung-Cancer (NSCLC) p. EML4-ALK translocation was first identified as an oncogene in NSCLC p in 2007. To date, published real-world data on the prognostic factors of patients with ALK-positive advanced NSCLC in Spain are limited. We aim to evaluate the effect of number of metastases (M1) organs on overall survival (OS) in a multicenter cohort of Spanish ALK-positive NSCLC p diagnosed between 2008 and 2017.
Method
We included p with stage IV at diagnosis since 2011 to April 2018. OS (months [m]) was estimated with the Kaplan-Meier method. Survival curves were compared between groups of p using the log-rank test. Hazard risk (HR) to death was estimated with multivariable Cox model, adjusted by site of metastases, gender, age and first line type of treatment.
Result
Out of the 163 p in the cohort a total of 98 p were included, with a median follow-up of 28.6 m and 45 deaths reported. Characteristics at diagnosis were median age 58 years, female 46.9%, never-smokers 59.2%, 50% with comorbidities, PS by ECOG 0-1 93%, 58.2% lung M1, 45.9% central nervous system M1, 42.9% bone M1, 22.4% liver M1 and 29.6% pleural M1.
54.3% p and 89.4% p were treated with ALK inhibitors as first line and second line respectively. The median OS was 34.4 months, being 46.9 months in p treated with ALK inhibitors and 38.8 months in p treated with chemotherapy as first line (p= 0.9).
There were 72 p who presented M1 in more than one organ and 26 p in a single organ. The risk of death increased with greater number of organs involved at diagnosis (HR= 3.0, p=.016), and presenting liver M1 at diagnosis (HR=2.2, p=.046, with OS of 19.1 m), compared to p single site involvement (OS: 45.4 m).
Conclusion
OS was worse with increased metastatic sites involved at diagnosis in p with ALK positive NSCLC, being liver M1 associated with the highest risk of mortality. Brain metastases at diagnosis were not a prognostic factor for OS in our series.
