182P - Intracranial response to nivolumab in NSCLC patients with untreated or progressing CNS metastases

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Non-Small-Cell Lung Cancer, Metastatic
Cancer Immunology and Immunotherapy
Presenter Elizabeth Dudnik
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors E. Dudnik1, S. Yust-Katz2, H. Nechushtan3, A. Zer1, D. Flex1, T. Siegal2, N. Peled1
  • 1Thoracic Cancer Unit, Rabin Medical Center Davidoff Cancer Centre, Beilinson Campus, 49100 - Petach Tikva/IL
  • 2Center For Neuro-oncology, Rabin Medical Center Davidoff Cancer Centre, Beilinson Campus, Petach Tikva/IL
  • 3Oncology Department, Hadassah Ein Kerem, Jerusalem/IL

Abstract

Background

Central nervous system (CNS) metastases occur in 30% of patients (pts) with advanced non-small cell lung cancer (NSCLC). Local treatment strategies result in delays in systemic therapy administration and are associated with neurocognitive impairment. Nivolumab is an anti-PD1 immune check-point inhibitor which was recently approved by FDA as a second line treatment of NSCLC. Data regarding its intracranial activity is lacking.

Methods

We reviewed efficacy and safety of nivolumab 3 mg/kg q2weeks in five pts with advanced NSCLC and new/progressing intracranial metastases.

Results

Pt baseline characteristics were as follows: median age 78 y (range, 52–84); 2 males; 4 smokers; ECOG PS: 0/1/2 – 2 pts/1 pt/2 pts; histological subtype: adenocarcinoma/squamous-cell carcinoma/NSCLC NOS – 3 pts/1 pt/1 pt; EGFR WT/ALK neg/KRAS M all/all/2 pts. All pts had parenchymal brain metastases, two pts had leptomeningeal disease. All pts were asymptomatic and did not require corticosteroids or immediate local therapy. Dramatic response in the brain was observed in two pts (including one pt with leptomeningeal spread demonstrating a partial response in the CNS); time-to-response comprised 5 weeks and 9 weeks; all responses are still ongoing at the time of the report (15+ weeks, 13+ weeks). In one additional pt stabilization of leptomeningeal carcinomatosis for 10 weeks was achieved. Systemic responses and intracranial responses were largely concordant. No treatment-related or CNS metastases-related grade ≥3 adverse events were observed.

Conclusions

Nivolumab has a promising intracranial activity and favorable safety profile in pts with NSCLC and untreated/progressing CNS metastases. Nivolumab CNS activity warrants further evaluation.

Clinical trial identification

Not a clinical trial, retrospective analysis

Legal entity responsible for the study

Davidoff Cancer Center, Rabin Medical Center

Funding

Bristol-Myers Squibb provided nivolumab for patients. No research funding or other kind of support was received from the pharmaceutical company.

Disclosure

S. Yust-Katz: Honoraria for lectures paid by BMS. N. Peled: Honoraria for lectures, consultant and advisor for BMS. All other authors have declared no conflicts of interest.