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Immunotherapy of cancer

5037 - Analyzing biomarkers of cancer immunotherapy (CIT) response using a real-world clinico-genomic database

Date

11 Sep 2017

Session

Immunotherapy of cancer

Presenters

Gaurav Singal

Citation

Annals of Oncology (2017) 28 (suppl_5): v403-v427. 10.1093/annonc/mdx376

Authors

G. Singal1, P.G. Miller2, V. Agarwala3, G. Li4, A. Gossai5, L.A. Albacker6, M.E. Goldberg6, J. He4, S. Frank5, D. Bourque7, I. Ivanov5, D. Fabrizio8, T. Caron5, A. Parker7, A. Guria4, V.A. Miller9, J.A. Elvin10, J.S. Ross10, A. Abernethy11, P.J. Stephens6

Author affiliations

  • 1 Data Strategy, Foundation Medicine, 02141 - Cambridge/US
  • 2 Oncology, Dana Farber Cancer Institute, Boston/US
  • 3 Product, Flatiron Health, Inc., New York/US
  • 4 Data Science, Foundation Medicine, Cambridge/US
  • 5 Data Science, Flatiron Health, Inc., New York/US
  • 6 R&d, Foundation Medicine, Cambridge/US
  • 7 Data Strategy, Foundation Medicine, Cambridge/US
  • 8 Cancer Immunotherapy, Foundation Medicine, Cambridge/US
  • 9 Medical Group, Foundation Medicine, Cambridge/US
  • 10 Pathology, Foundation Medicine, Cambridge/US
  • 11 Medical Group, Flatiron Health, Inc., New York/US
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Resources

Abstract 5037

Background

Highly discriminating biomarkers of response to cancer immunotherapies (CIT) remain elusive. Characterization of large real-world populations treated with CIT as part of routine care may enable better stratification.

Methods

Patients in the Flatiron Health Analytic Database with non-small cell lung cancer (NSCLC) who underwent comprehensive genomic profiling (CGP) by Foundation Medicine were included (n = 2139). CGP included >300 genes and tumor mutation burden (TMB), stratified into low (TMB-L;  =20 mut/MB) tertiles (Johnson, CIR 2016). PD-L1 expression was obtained from results reported to clinicians from multiple labs (using varying antibodies). Genomic data was linked to de-identified electronic health record (EHR) data, from which nivolumab response was measured as overall response rate (ORR = SD, PR, or CR), median duration of therapy (mDOT), and median overall survival (mOS) from advanced diagnosis and from nivolumab initiation.

Results

In patients treated with nivolumab (n = 444, 20.8%), TMB-H predicted longer mDOT than TMB-L/I (7.5 vs 4.6 months, p = 0.001), mOS from start of nivolumab treatment (median not reached vs 10 months, p 

Conclusions

Real-world datasets combining clinical outcomes with genomic profiling may enable biomarker discovery in CIT. These data demonstrate the predictive power of TMB, which can augment and significantly improve on the currently approved PD-L1 expression as a predictor of CIT response. They may also enable discovery of novel biomarkers that can identify potential CIT responders among TMB-L populations.

Clinical trial identification

Legal entity responsible for the study

Foundation Medicine, Inc. and Flatiron Health, Inc.

Funding

None

Disclosure

G. Singal: Employee of Foundation Medicine, Inc., with equity and salary. P.G. Miller: Consultant with Foundation Medicine, Inc. V. Agarwala: Employee and shareholder of Flatiron Health, Inc. G. Li, L.A. Albacker, M.E. Goldberg, J. He, D. Bourque, D. Fabrizio, A. Parker, A. Guria, V.A. Miller, J.A. Elvin, J.S. Ross, P.J. Stephens: Employee and shareholder of Foundation Medicine, Inc. A. Gossai, S. Frank, I. Ivanov, T. Caron, A. Abernethy: Employee and shareholder of Flatiron Health, Inc.

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