Author of

• 36050

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  P01 - Antibody Drug Conjugates, Novel Therapeutics and Cytotoxics (ID 227)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Antibody Drug Conjugates, Novel Therapeutics and Cytotoxics
  • Presentations: 2
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 36062

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    P01.10 - Patients Experienced Pseudoprogression to Anti-PD-1/PD-L1 Inhibitor Have Better Response Than Those Without in Lung Cancer (ID 1774)

    00:00 - 00:00  |  Presenting Author(s): Wencheng Zhao
    • Abstract

    Introduction
    

    Pseudoprogression present to be an atypical pattern of response for anti-PD-1/PD-L1 immunotherapy (IO) in lung cancer. It happens uncommon and we have limited knowledge about it.

    Methods
    

    Lung cancer patients treated with anti-PD-1/PD-L1 from May 2016 to October 2019 in Shanghai Pulmonary Hospital were retrospectively reviewed. Pseudoprogression was defined as progression from baseline and followed by response from peak. We analyzed incidence, time course, clinical characteristics, treatment and outcomes. Propensity Score Matching (PSM) was applied to adjust for potential confounding factors. Progression-free survival (PFS) was estimated with Kaplan-Meier method.

    Results
    

    Totally, 15 out of 449 pts were identified with pseudoprogression and one patient received re-biopsy for the pseudoprogressive lesion. All patients were male with a median age of 64 (range: 52-76), most (86.7%) were ever smokers，had histologic subtype of adenocarcinoma(n=8), squamous(n=5)，NSCLC-NOS(n=1) and SCLC(n=1), and had stage IIIc (n=1), stage IV (n=14). Two pts were found with EGFR mutation (1with 19Del and 1 with G719X) and 1 pt was identified with KRAS mutation. The IO used were pembrolizumab (n=5), Atezolizumab(n=1) and domestic PD-1 inhibitors (SHR1210 n=3, BGB-A317 n=2, IBI308 n=2 and JS001 n=2). Eight pts treated with single agent, 5 with combination of chemotherapy, and 3 with combination of anti-angiogenesis. Three pts were used as first line, 8 as second line and 4 as third line. Pseudoprogression occurred at a median time of 9 weeks (range: 2-46), 13/15 of cases happened within six month, one in nine month and one in twelve month. Among them, 13 pts had enlarged primary lung lesions and 2 patients had enlarged bilateral pulmonary nodules, no pts had enlargement of distant metastatic lesions. The overall response rate is 40%, and disease control rate was 100%. After adjustment for pts’ age, gender, treatment line, combining therapy type with the PSM method, we found PFS is significantly longer in pseudoprogression cohorts than control cohorts: 9.6 month (95% CI:0-22.5) vs 4.2 month (95% CI:3.4-5.0), P=0.02. One SCLC patient received rebiopsy at the time of pesudoprogression showed obvious lymphocyte infiltration and no cancer cells.

    Conclusion
    

    Patients who experienced pseudoprogression with IO have obviously longer PFS than those without. Further studies in larger cohort are needed to confirm this finding.

  • 36065

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    P01.13 - Anti-PD1 Inhibitors Combined With Anti-Angiogenesis Showed Superior Efficacy in Control of Malignant Pleural Effusion for NSCLC (ID 2063)

    00:00 - 00:00  |  Presenting Author(s): Wencheng Zhao
    • Abstract

    Introduction
    

    Malignant pleural effusion (MPE) is closely associated with patients' quality of life, and is not easy to control by chemotherapy and targeted therapy. This study aim to investigate efficacy of control of MPE in the era of immunotherapy (IO) and compare control rate with different treatment strategies.

    Methods
    

    NSCLC patients treated with anti-PD1 from May 2016 to October 2019 in Shanghai Pulmonary Hospital were retrospectively reviewed. MPE was defined as finding malignant cells in pleural fluid. Pleural effusion control rate (PECR) was defined as the percentage of patients whose MPE without re-accumulation for 8 weeks. Chi-Square test was used for comparing categorical variables. Kaplan Meier method was applied to compared progression-free survival (PFS).

    Results
    

    53 out of 449 patients with MPE were enrolled. Baseline characteristics were: men:67.9%; median age:63(33-76 years); ECOG PS 0-1:92.5%; ever smokers:67.9%; adenocarcinoma: 83% and 26.4% patients received 1st line treatment. Among them, 15 patients treated with anti-PD1 monotherapy, 8 pts with combination of multiple kinase inhibitor Apatinib, 30 pts with combination of chemotherapy (21 with pemetrexed/ platinum, 5 with nab-Paclitaxel, 3 with Docetaxel and 1 with Gemcitabine plus cisplatin). Overall response rate (ORR) and disease control rate (DCR) for targeted lesion were 18.9% and 75.5% respectively. PECR was 67.9% for MPE. At last follow-up, 40 patients experienced disease progression and 50% patients got re-accumulation of MPE. The PECR of Apatinib-combining group was higher than chemotherapy-combining group: 100% vs 66.7% (p=0.08), also higher than monotherapy group: 100% vs 53.3% (p=0.05). The difference is not statistically different due to small sample size. But the PECR in Apatinib-combining group is obviously higher than non Apatinib-combining group: 100% vs 62.2%, p=0.04. The PFS was 10.6 month (95%CI 3.64-17.56) versus 3.6 (95%CI 1.74-5.46) separately, p=0.01.

    Conclusion
    

    The combination of anti-PD1 with Apatinib demonstrates superior efficacy in controlling MPE for NSCLC patients. Large prospective studies are needed to confirm this finding.