1226P - An interim assessment of key biomarkers (programmed cell death receptor ligand 1 (PD-L1) expression and epidermal growth factor receptor (EGFR) in...

Date 08 October 2016
Event ESMO 2016 Congress
Session Poster Display
Topics Non-Small Cell Lung Cancer
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter Deirdre Cronin-Fenton
Citation Annals of Oncology (2016) 27 (6): 416-454. 10.1093/annonc/mdw383
Authors D. Cronin-Fenton1, T. Dalvi2, E. Hedgeman3, M. Norgaard1, L. Pedersen1, K. Mortensen4, A. Midta5, N. Shire2, R. Brody2, J. Fryzek6, D. Lawrence7, J. Rigas8, D. Potter2, J. Walker9, A. Mellemgaard10, T.R. Rasmussen11, S. Hamilton-Dutoit4, H.T. Sørensen1
  • 1Clinical Epidemiology, Aarhus University Hospital, 8200 - Aarhus C/DK
  • 2Medical Evidence & Observational Research, AstraZeneca, Gaithersburg/US
  • 3Epidemiology, EpidStat Institute, Ann Arbor/US
  • 4Institute Of Pathology, Aarhus University Hospital, Aarhus C/DK
  • 5Personalised Healthcare And Biomarkers, AstraZeneca, Macclesfield/GB
  • 6Epidemiology, Epidstat Institute, Rockville/US
  • 7Biostatistics And Information Sciences, AstraZeneca, Cambridge/GB
  • 8Geisel School Of Medicine, Dartmouth College, Hanover/US
  • 9Personalised Healthcare And Biomarkers, AstraZeneca, Cambridge/GB
  • 10Oncology, University Hospital Herlev, Herlev/DK
  • 11Respiratory Medicine, Aarhus University Hospital, Aarhus C/DK

Abstract

Background

Among NSCLC patients who received third-line therapy, we examined the association of PD-L1 expression and EGFR mutations with survival.

Methods

Third-line therapy NSCLC patients diagnosed during 2001-2012 were selected from the Danish Lung Cancer Group Registry. We retrieved patient data from population-based medical registries, and paraffin-embedded tumor tissue from pathology archives. We assessed PD-L1 expression using the Ventana IHC (SP263) validated assay (using 25% cutoff for high versus low), and genotyped EGFR to identify mutations at Exon 18 (G719X (G719A, G719C, and G719S), Exon 19 (deletions and complex mutations), Exon 20 (S768I, T790M, and insertions), and Exon 21 (L858R) via a PCR-based kit. Follow-up was from third-line therapy start to the first of death, emigration, or 31/12/2014. We used Cox regression to compute hazard ratios (HR) and associated 95% confidence intervals (95% CI) for PD-L1 and EGFR.

Results

Among 344 third-line therapy patients, 185 (54%) were men, 165 (48%) were aged >60 years at diagnosis, and the majority were ever-smokers. 200 (58%) had adenocarcinoma histology, 85 (25%) had high PD-L1 expression in their tumors and 27 (8%) had EGFR mutations. Compared to patients with wildtype EGFR tumors, those with EGFR mutations less often showed high PD-L1 expression (21%, 95%CI = (4%, 38%) versus 25%, 95%CI = (19%, 31%); Fisher's exact p-value = 0.81). Median overall survival differed little by PD-L1 status, but was longer in patients with mutant compared with wildtype EGFR. Neither PD-L1 expression nor EGFR mutations were significantly associated with survival.

N No. of deaths Median Survival (months) (95%CI) Adjusted HR* (95%CI)
PD-L1 low 249 208 8.0 (6.6, 9.1) ref.
PD-L1 high 85 72 8.3 (6.1, 11.6) 0.89 (0.68, 1.17)
EGFR
Wildtype 260 213 7,7 (6.5, 8.8) ref.
Mutant 27 22 11.0 (6.9, 22.1) 0.79 (0.51, 1.24)

*Adjusted for age, sex, histology (adenocarcinoma versus other)

Conclusions

Our findings suggest no association of PD-L1 expression or EGFR mutations with survival in third-line therapy NSCLC patients.

Clinical trial identification

Not applicable

Legal entity responsible for the study

N/A

Funding

AstraZeneca

Disclosure

T. Dalvi: TD is an employee and shareholder of MedImmune/AstraZeneca. E. Hedgeman: Funding to support this work from AstraZeneca Inc., Gaithersburg, MD 20878. A. Midta, N. Shire, R. Brody, D. Lawrence, D. Potter, J. Walker: Employee and shareholder of AstraZeneca. J. Fryzek: JPF was employed by AstraZeneca, 2009-2011. JPF received funding to support this work from AstraZeneca Inc., Gaithersburg, MD 20878. J. Rigas: Consultant physician to AstraZeneca. A. Mellemgaard: Honoraria and/or travel expenses from Lilly, Boehringer Ingelheim, BMS, MSD. S. Hamilton-Dutoit: Research funding from AstraZeneca. Honoraria or consulting Amgen. H.T. Sørensen: Research funding from Epidstat. All other authors have declared no conflicts of interest.