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Aurora Mendes
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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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EP1.04-10 - Nivolumab in Non-Small Cell Lung Cancer (NSCLC): A Real-Life Study (ID 2012)
08:00 - 18:00 | Author(s): Aurora Mendes
- Abstract
Background
Immunotherapy is an option in locally advanced or metastatic lung cancer (LC), depending on the PD-L1 value. Nivolumab, an anti-PD1 immunological checkpoint inhibitor, can be used in LC in subsequent lines, regardless of the PD-L1 value. The aim of this study was to analyze patients with LC treated with nivolumab in the Multidisciplinary Thoracic Tumor Unit (MTTU) of our hospital.
Method
Retrospective analysis of patients treated in the MTTU of our hospital who with nivolumab in subsequent lines between Dec-2015 and Dec-2018.
Result
49 patients were enrolled in this study with a mean age at the start of immunotherapy of 62.1 ± 9.1 years. 38 patients (77.6%) were male. Regarding the histological type, 30 (61.2%) were adenocarcinomas, 16 (32.7%) squamous cell carcinomas and 3 (6.1%) corresponded to other histological types. Regarding the expression of PD-L1, 30 patients (61.2%) had no expression, 13 (26.5%) had PD-L1 ≥1%, and in 6 patients (12.2%) this parameter was unknown. 27 patients (55.1%) were treated with 1 prior therapeutic line, 12 patients (24.5%) with 2 and 10 patients (20.3%) with > 2 previous therapeutic lines. With immunotherapy, 7 (14.3%) had partial response, 22 (44.9%) stable disease and 12 (24.5%) progressive disease. 28 patients (57.1%) have died so far.
The median PFS was 5 months (95% CI 1.4-8.6) and the median overall survival (OS) was 10 months (95% CI 7.6-12.4). There were no significant differences between patients with or without PD-L1 expression.
Conclusion
The OS of our patients treated with nivolumab was slightly lower than some literature which perhaps is related to the fact that this is a real-life study, patients had a high number of previous therapeutic lines and there were different histologic types of LC.
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EP1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 206)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 2
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.16-16 - Pembrolizumab as First Therapeutic Line in Non-Small Cell Lung Cancer – The Experience of a Portuguese Tertiary Hospital (Now Available) (ID 2895)
08:00 - 18:00 | Author(s): Aurora Mendes
- Abstract
Background
Pembrolizumab is a humanized monoclonal antibody against PD-1 that has antitumoral activity in NSCLC. It is currently approved by the EMA for the treatment of patients with advanced NSCLC with PD-L1 expression ≥50%.
Method
A retrospective study was performed in patients with advanced NSCLC proposed for first-line treatment with pembrolizumab. These patients were recruited at our Thoracic Tumor Unit between June 2017 and December 2018. An epidemiologic characterization of patients was performed and a progression-free survival (PFS) was analysed through the Kaplan-Meier method.
Result
Twenty-two patients were included, with one being excluded due to the presence of synchronous tumor lesions. The majority of patients were male (90,5%), with a mean age of 63±13 years and 85.7% were smokers or former smokers. At the start of immunotherapy, 23.8% had a PS0 and 76.2% had a PS1. The most frequent histology was adenocarcinoma (57.1%), followed by squamous cell carcinoma (33.3%), and the majority of patients were in stage IV (95.2%). The median of PD-L1 expression was 80% (IQR 30).
Partial remission was achieved in 47.6% of patients, stable disease in 28.6%, and 23.8% of patients had progressive disease. The median PFS was 10.0 months. Adverse effects were documented in 28,6% of patients, namely hypothyroidism, colitis, hepatitis and sialadenitis. Only one was classified as grade 3 according CTCAE, leading to interruption of the drug.
Conclusion
The PFS obtained in our study was similar to that described in literature (10.3 months). As we can observe the safety profile of pembrolizumab was also good. Thus, pembrolizumab is increasingly being shown as a well-established drug in 1st line for advanced NSCLC with PD-L1 expression ≥50%.
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EP1.16-20 - Pembrolizumab - Subsequent Lines in Non-Small Cell Lung Cancer: The Experience of a Tertiary Hospital (Now Available) (ID 2908)
08:00 - 18:00 | Author(s): Aurora Mendes
- Abstract
Background
Pembrolizumab is currently approved for the treatment of metastatic NSCLC, with PD-L1 expression ≥1% and with progressive disease during or after treatment with chemotherapy.
Method
A retrospective study was conducted in patients with metastatic NSCLC with ≥ 1% of PD-L1 expression, proposed for subsequent therapeutic lines with pembrolizumab. Patients were recruited in our Thoracic Tumor Unit between June 2017 and December 2018. An epidemiology characterization of patients was performed and progression-free survival (PFS) was analyzed throw a Kaplan-Meier method.
Result
Fourteen patients were included. The majority of patients were male (85.7%), with a mean age of 65±11 years, and 78.6% of them were smokers or former smokers. The observed PS was: PS0 in 7.1% and PS1 in 92.9%. The most prevalent histologies were adenocarcinoma (71.4%) and squamous cell carcinoma (28.6%), with the majority of patients in stage IV (78.6%) at the time of initiation of pembrolizumab. The median of PD-L1 expression was 60% (IQR 50). Mutations and translocations (KRAS and BRAF) were present in 38.5% of these patients.
Partial disease remission was achieved in 28.6% of patients, stable disease in 50.0%, and 21.4% of patients progressed. The median PFS was 8.0 months. Adverse effects were documented in 28.6% of patients, namely hypothyroidism (28.6%) and hepatitis (7.1%). Only one patient developed grade 3 adverse effect that led to drug interruption.
Conclusion
The PFS obtained in our study was twice as large as that described in the literature (3.9 months), although due to the small number of patients it was not possible to divide in subgroups of PD-L1 expression. However, the high median of PD-L1 expression in our study may explain in part the results obtained. The authors intend to show that pembrolizumab in 2nd line is an effective drug and should be considered in patients with high expression of PD-L1.
