Virtual Library

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    P1.07 - Immunology and Immunotherapy (ID 693)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Immunology and Immunotherapy
    • Presentations: 1
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      P1.07-028 - Determination of Soluble PD-L1 as a Potential Biomaker for Anti-PD(L)1 Therapy in Non-Small Cell Lung Cancer (NSCLC) (ID 9781)

      09:30 - 16:00  |  Presenting Author(s): Margarita Majem Tarruella  |  Author(s): A. Barba Joaquín, C. Zamora Atenza, S. Vidal Alcorisa, I.G. Sullivan, G. Anguera Palacios, M.A. Ortiz De Juana, M. Andrés Granyò, A.C. Virgili Manrique, N. Dueñas Cid, A.C. Vethencourt Casado, L.P. Del Carpio Huerta, P. Gomila Pons, S.D. Camacho Arellano, S. Moron Asensio, M. Riudavets Melia, C. Molto Valiente, A. Callejo Perez

      • Abstract

      Background:
      PD-L1 has been established as a predictive marker for anti-PD(L)1 treatment, although patients negative for PD-L1 may also respond to those treatments. Soluble PD-L1 (sPD-L1) in blood has been described as prognostic factor in advanced NSCLC. To date, no evidence of efficacy of anti-PD(L)1 treatment according to sPD-L1 has been reported. The objective of this study is the correlate the efficacy of anti-PD(L)1 treatment according to sPD-L1 in our patients.

      Method:
      Baseline sPL-L1 levels were prospectively determined in pretreated advanced NSCLC patients receiving anti-PD(L)1 treatment. sPD-L1 levels (high (H) and low (L)), were calculated based on the median value of sPD-L1, and those values were correlated with OS and PFS for all patients and for according to histology. sPD-L1 levels were also correlated with leucocyte and platelet count and PD-L1 expression in tumor.

      Result:

      sPD-L1
      OS (m) PFS (m)
      H L H L
      Adenocarcinoma (n: 19) 10.3 (5.3-17.4) 14.3 (10.1-18.5) 5.8 (0.9-10.7) 8.7 (4.0-13.4)
      P 0.7 P: 0.7
      Squamous cell carcinoma (n: 11) 16.1 (7.5-24.8) 14.7 (9.4-20.0) 11.4 (2.5-20.3) 6.9 (3.2-10.7)
      P: 0.8 P:0.7
      All (n:30) 13.2 (9.2-17.2) 15.4 (12.0-18.9) 4.2 (0.4-7.9) 6.0 (0.6-11.3)
      P: 0.2 P: 0.5
      In patients with adenocarcinoma, a positive correlation was observed between sPD-L1 levels and monocyte count (R[2]:0.44; p: 0.0008), and with the ratio platelet/lymphocyte (R[2]:0.55; p<0.0001). In all NSCLC patients and squamous cell carcinoma, a positive correlation was observed between sPD-L1 levels and neutrophil count (R[2]:0.42; p: 0.002 and R[2]:0.59; p: 0.0025 respectively). No correlation between sPD-L1 level and PD-L1 expression in tumor was observed (n: 22 patients; p: 0.9065)

      Conclusion:
      Although no significant differences in OS or PFS were observed according to sPD-L1, a trend to a better OS was seen in NSCLC patients with low sPD-L1, especially in patients with adenocarcinoma. Prospective studies analyzing sPD-L1 levels and other PD-L1 variants are needed to find possible new biomarkers for anti-PD(L)1 treatments in NSCLC.

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    P2.01 - Advanced NSCLC (ID 618)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P2.01-072 - Local Management of Oligometastasis in Non-Small Cell Lung Cancer (NSCLC) (ID 10104)

      09:00 - 16:00  |  Presenting Author(s): Margarita Majem Tarruella  |  Author(s): M. Riudavets Melia, L.P. Del Carpio Huerta, A. Barba Joaquín, G. Anguera Palacios, I.G. Sullivan, A. Callejo Perez, N. Farré, A. Torrego, V. Pajares, E. Martínez, J.C. Trujillo, C. De Quinana

      • Abstract

      Background:
      Stage IV NSCLC patients with oligometastasis may experience long-term survival when macroscopic tumour sites are treated radically. The aim of this abstract is to analyse our experience in local management of oligometastasis in NSCLC.

      Method:
      We retrospectively analysed 38 patients with oligometastatic NSCLC in terms of overall survival (OS), progression-free survival from diagnosis (SLP) and treatment (SLPT) of oligometastatic disease and the association with clinical features such as age, gender, histology, molecular profile, stage at diagnosis and metastatic sites. Kaplan Meier method was used.

      Result:
      We analysed 38 patients (25 men, 13 women). Mean age: 61 years (40-82). Histology: 60% adenocarcinoma, 8% squamous carcinoma, 13% large cell carcinoma, 19% NOS. 2 EGFR and 1 BRAF mutations. 60% patients (23/38) presented oligometastatic NSCLC at diagnosis, 34% after progression of early disease and 6% after response to initial systemic treatment for advanced disease. Mean number of metastasis: 1 (1-3). Most frequent location: brain (80%). 35% of patients (8/23) oligometastatic at diagnosis received local treatment for the primary tumour: 75% surgery, 25% radiotherapy. Systemic therapy was administrated in 65% of patients (15/23): 93% platinum-based chemotherapy, 7% EGFR-TKI. Table 1 shows local treatment for oligometastasis at diagnosis. No severe complications were observed.

      Table 1 Brain (n=30, 80%) Adrenal gland (n=4, 10%) Lung (n=3, 8%) Liver (n=1, 2%)
      Surgery + Radiotherapy 87% (26/30)
      Surgery 10% (3/30) 50% (2/4) 67% (2/3)
      Radiotherapy 33% (1/3)
      No local treatment 3% (1/30) 50% (2/4) 100% (1/1)
      With a median follow up of 23 months (95%CI 0.9-78.2m), median SLPT was 8.5 months (95%CI 5.3-11.7m), median SLP was 8.7 months (95%CI 6.1 – 11.3m) and median OS was 9.9 months (95%CI 0-32). Median OS of brain metastasis was 9.7 months (95%CI 6.5-12m) vs not reached in patients without brain metastasis (p 0.019). Median OS patients with oligometastatic NSCLC at diagnosis was 8.7 months (95%CI 5'9-11) vs not reached in the rest of patients (p 0.025).

      Conclusion:
      Data collected demonstrate that survival rate in patients with oligometastatic NSCLC is similar to that reported in literature. Cerebral metastasis significantly worsen the prognosis.

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    P1.01 - Advanced NSCLC (Not CME Accredited Session) (ID 933)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
      • Abstract

      Background

      Immune-checkpoint inhibitors (ICIs) are a standard treatment in advanced non-small cell lung cancer (NSCLC). However, ICIs can induce immune-related adverse events (irAEs) that may compromise treatment continuation. Here we report our experience in patients with NSCLC, the incidence of irAEs and its correlation with efficacy.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We have retrospectively analyzed 101 patients with advanced NSCLC receiving ICIs in our institution from March 2014 to January 2018. IrAEs were graded following CTCAE v4.0. Kaplan Meier and log-rank tests were used to evaluate progression-free (PFS) and overall survival (OS). Analyses were performed using SPSS v24 package.

      4c3880bb027f159e801041b1021e88e8 Result

      Median age was 66.4 [37-85] years, 74.3% were male. 33 (32.7%) patients presented squamous and 68 (67.3%) non-squamous histology. Most frequent ICIs were nivolumab (50%), pembrolizumab (31%) and atezolizumab (16%), used as monotherapy (79.2%) or in combination with chemotherapy (20.8%). 37.6% patients were treated with ICIs in first line setting, while 62.4% in second or beyond. Median duration of treatment was 2.7 [0.6-26.2] months.

      61 (60.4%) patients developed 106 irAEs, with a mean of 1.02 [0-4] irAEs per patient. Most frequent irAEs were rash (24.5%), pruritus (22.6%), diarrhea (21%), arthritis (8.5%), hypothyroidism (7.6%), hyperthyroidism (2.9%), hepatitis (2.9%) and pneumonitis (2%). 8 (7.5%) patients experienced grades (G) 3-4 irAEs: 1 G3 pneumonitis, 4 G3 diarrhea, 1 G3 mucositis, 1 G3 nephritis and 1 G3 hemolytic anemia. One treatment-related death due to pneumonitis was reported.

      Patients receiving ICIs in second line or beyond experienced significantly less irAEs (54.1%) than those treated in first line (73.7%), p 0.04.

      47 (46.5%) patients received systemic corticosteroids during immunotherapy, 29.8% for irAEs management. 11 patients (10.9%) discontinued treatment due to irAEs. At the time of data analysis, 86.8% of irAEs had improved.

      With a median follow-up of 8.9 [0.6-48.2] months, median OS was superior in patients experiencing irAEs: not reached (NR) vs 7.8 [95%CI, 5.2-10.5] months (p 0.001). Similarly, PFS was significantly longer: 6.2 [95%CI, 2.3-10.1] vs 2.7 [95%CI, 1.8-3.5] months (p <0.0001). OS was higher in patients who did not receive steroids during ICIs therapy: NR vs 9.9 [95%CI, 6.8-13.0] months (p 0.024). No association was found between efficacy and the use of antibiotics in the 3 months before first ICIs injection or during treatment.

      8eea62084ca7e541d918e823422bd82e Conclusion

      In our series, the presence of irAEs in patients with advanced NSCLC treated with ICIs was associated with efficacy in terms of PFS and OS. A negative correlation between usage of systemic corticosteroids and outcomes was found.

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