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Erika Broström



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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
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.04-18 - Real-World Treatment with Checkpoint Inhibitors: The Swedish Experience (Now Available) (ID 2590)

      08:00 - 18:00  |  Author(s): Erika Broström

      • Abstract
      • Slides

      Background

      The introduction of checkpoint inhibitors has fundamentally changed the treatment of advanced NSCLC patients.

      Method

      In order to evaluate if the encouraging results from clinical trials translates into the clinical routine and to confirm the value of biomarker testing we evaluated NSCLC patients that were treated with a checkpoint inhibitor in the Uppsala-Gävle health care region between Januari 2016 and October 2018. Latest patient follow up was done in March 2019. Patient information, including therapy, response rates and survival were obtained from patient records

      Result

      In total, 86 patients, were identified (44 female, median age 71 years; performance status 0=18, 1=45; 2-3=23). 28 patients were treated in the first line setting and 58 patients after previous chemotherapy. Checkpoint inhibitors that were given included pembrolizumab (31), nivolumab (36), atezolizumab (7). Two patients received a combination (durvalumab och tremelimumab).

      67 of 86 patients were evaluable for response and of these 23 patients showed progressive disease, 17 stable disease, 22 partial response and 5 complete response. However, most patients that were not evaluable for response either had only 1-2 cycles because of severe side effects or died early independent from treatment. Thus, for all patient treated with at least one course of checkpoint inhibitors response rate were lower (SD:20%; PR:26% and CR:6%). PD-L1 analysis was done for 69/86 patients (80%). The response (PR or CR) was numerically higher in the group with PD-L1 positivity ≥1% or ≥50% than with negative PD-L1 expression (54% vs 47% vs 13%), although not statistically significant (p=0.11). Median overall survival for patients with PD-L1 <1% was 2.3 years, for patients PD-L1 ≥1% 2.7 years and PD-L1≥50% 3.9 years (log rank-test, p=0.95).

      Conclusion

      In conclusion, the response rates to checkpoint inhibitors in the first and second line were comparable to those observed in clinical trials. We confirmed that patients with low PD-L1 expression are unlikely to respond to checkpoint inhibition.

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