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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

  • 31967

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    EP1.04-30 - RECIST and iRECIST Comparison in a Cohort of Patients with Advanced NSCLC Treated with Immunotherapy: Preliminary Study (Now Available) (ID 2563)

    08:00 - 18:00  |  Author(s): Isabel Torres Sánchez
    • Abstract
    • Slides

    Background
    

    Nivolumab, Pembrolizumab and Atezolizumab are anti-programmed death-receptor-1 (PD-1) and anti-programmed-death-ligand 1 (PD-L1) immunotherapy agents used in the treatment of advanced non-small cell lung cancer (NSCLC). Howewer, its radiological evaluation is challenging because of atypical patterns of response and immune-related adverse events. This study aims to (i) compare the Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1, with the Immune RECIST (iRECIST) and (ii) explore the association of response patterns and clinical outcome.

    Method
    

    We conducted a retrospective study of previously treated patients with advanced NSCLC who received Nivolumab, Pembrolizumab or Atezolizumab (first and second line). All CT scans were reviewed by two radiologists specialized in immunotherapy evaluation (1 senior, 1 junior). Tumor response was assessed according to both RECIST v1.1 and iRECIST C.

    Result
    

    Were included 39 patients (27 male, 12 female) between November 2014 and December 2018 with advanced NSCLC. Median of age was 64 years (range 43 to 86). 13 patients (33,3 %) were treated with Nivolumab, 18 patients (46,1 %) with Pembrolizumab and 8 patients (20,5 %) with Atezolizumab. Among of 100% of patients included, 35,9 % showed partial response (PR), 20,5% stable disease (SD) with RECIST and iRECIST criteria. 43,6 % of patients showed progressive disease (PD) with RECIST criteria but only 4 of them were confirmed progressive disease (iCPD) with iRECIST criteria (2 truly progressed and died, 1 showed PR with the treatment and 1 reached SD). 8 patients with PD (20,5 %) could not be confirmed with iRECIST, remaining as unconfirmed progressive disease (iUPD), 5 of them because of patient’s death, 1 because a change of therapy was performed and 2 because they reached SD within the treatment. The remaining 4 patients with PD presented improvement within the treatment after the initial progression (pseudoprogression).

    Conclusion
    

    In our study, both RECIST 1.1 and iRECIST criteria were valid for measuring the effectiveness of the treatment with Nivolumab, Pembrolizumab and Atezolizumab. No differences were found in the assessment of PR and SD.

    13 differences were detected between RECIST and iRECIST in the assessment of PD. RECIST criteria underestimated more the benefit of the treatment compared with iRECIST, but was better detecting true PD resulting in patient’s death than iRECIST (which could not always confirm the progression).

    Given the relatively small number of patients studied, further study is warranted on whether RECIST and iRECIST criteria are equivalent to evaluate new immunotherapy treatment in NSLC.

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