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Ana Rita Lopes



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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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      EP1.04-31 - Immunotherapy in Advanced Non-Small Cell Lung Cancer Previously Treated: Real World Data (Now Available) (ID 2716)

      08:00 - 18:00  |  Author(s): Ana Rita Lopes

      • Abstract
      • Slides

      Background

      Immunotherapy has changed the paradigm of the treatment and prognosis of Non-Small Cell Lung Carcinoma (NSCLC). Pembrolizumab and nivolumab are monoclonal antibodies that blocks PD-1, both approved in advanced NSCLC. The aim of this study was to evaluate the demographic, histological characteristics, response and toxicities of these drugs.

      Method

      This is a retrospective cohort of patients with metastatic NSCLC that had been treated with pembrolizumab or nivolumab in our institution, who began treatment until 12.2018.

      Result

      60 patients were included in this study. In pembrolizumab group (N27), 81.5% (22/27) were men, 53.8% (14/26) ex-smokers, median age 68 (45-79). Histologically, 81.5% (22/27) were adenocarcinomas, EGFR negative, one with ALK translocation and 48.1% (13/27) with PD-L1 levels > 50. At diagnosis 66.7% (18/27) was in stage IV. 1st line palliative chemotherapy was platinum/pemetrexed in most patients (59.3% 18/27). 81.5%(22/37) were treated with pembrolizumab in 2nd line. ECOG at the start of pembrolizumab was 1 in 74.1% (20/27). Median number of cycles was 8 (1-34). 42.3% (11/26) had toxicity, grade 3 in 4 patients, the most common being asthenia, anorexia and hypothyroidism. Treatment discontinuation occurred due to clinical deterioration in 33.3% (9/27) or 25.9% (7/27) disease progression. 7 patients (25.9%) maintained treatment. 12 patients die due to NSCLC (mortality: 44.4%).

      In nivolumab group (N 33), 78.8 % were men (26/33), median age 62 years (46-73), 54.5% (18/23) smokers. Histologically, 69.7% (23/33) were adenocarcinomas, EGFR positive in 2 patients, no ALK translocation and PD-L1 negative in all patients. 60.6% (20/33) were diagnosis in stage IV. 1st line palliative treatment was platinum/pemetrexed in most cases (63.6%, 21/33). 84.8% (28/33) were submitted at least to 2 lines of treatment before nivolumab. 81.8% (27/33) had ECOG1 at the start of nivolumab. Median number of cycles was 9 (1-50). 54.5% (18/33) of patients had toxicity, grade 3 in 5 patients, with asthenia and rash being the most common. Disease progression (42.4%; 14/33) and clinical deterioration (27.3%; 9/33) are the most reason for treatment discontinuation. 21 patients die due to cancer (mortality: 63.6%).

      At 12 months, progression-free survival was 33.3% in pembrolizumab and 64% in nivolumab.

      Conclusion

      Immunotherapy brought higher survival rate to NSCLC, with good tolerability in most cases, maintaining and improving the quality of life. However, given the disparities between responses, acknowledgment of new targets and biomarkers will make the patient selection for immunotherapy more accurate.

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