Author of

• 30601

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  P2.01 - Advanced NSCLC (ID 159)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Advanced NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 30657

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    P2.01-52 - Clinical Characteristics and Outcomes in NSCLC Patients Associated with Very High PD-L1 Expression (ID 1787)

    10:15 - 18:15  |  Author(s): Laura Hanson
    • Abstract

    Background
    

    Clinical characteristics and outcomes for patients with non-small cell lung cancer (NSCLC) and very high PD-L1 expression are unknown. We sought to better characterize this subset of patients with PD-L1 ≥90% to determine any differences in clinical presentation or survival.

    Method
    

    We performed a retrospective analysis of patients treated at our institution between 2014 and 2018 with metastatic NSCLC and an available PD-L1 result (any assay). We assessed tumor size, location of metastasis, and presence of mediastinal invasion using continuous PD-L1 values (Wilcoxon Mann-Whitney test) and compared two subgroups based on a PD-L1 cut point of ≥90% (Fisher’s exact test). Survival comparisons used Kaplan Meier log-rank methodology.

    Result
    

    A total of 101 patients were included in the analysis; 16.8% had PD-L1 ≥90%. A summary of the patient demographics and clinical characteristics are summarized in Table 1. Higher PD-L1 values were associated with mediastinal invasion (median PD-L1 60% vs 5% without invasion, p=0.0268) and those with PD-L1 ≥90% were more likely to have adrenal metastasis (p=0.0266). There was no correlation between tumor size or other sites of metastasis and PD-L1 expression. OS was not significantly different when compared to those with PD-L1 50-89% or lower PD-L1 subgroups in either immunotherapy alone treatment group (p=0.6358) or for the combination chemotherapy/ immunotherapy group (p=0.2580). Patients receiving immunotherapy alone with PD-L1 expression ≥90% had a median OS of 38.0 months compared to 21.3 months for PD-L1 0-89% (p=0.8480).

    Table 1:

    

    Conclusion
    

    Higher PD-L1 expression was associated with mediastinal invasion, and adrenal metastasis were more common in patients with PD-L1 ≥90%. While there were no detectable survival differences in the very high PD-L1 group, differences in clinical characteristics highlight the heterogeneity of this group of patients and need for further characterization that may be predictive of treatment response and help tailor treatments for this group.