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Poster display session

3986 - Baseline corticosteroids (CS) could be associated with absence of benefit to immune checkpoint inhibitors (ICI) in advanced non-small cell lung cancer (NSCLC) patients.

Date

09 Sep 2017

Session

Poster display session

Topics

Cancers in Adolescents and Young Adults (AYA);  Immunotherapy;  Non-Small Cell Lung Cancer

Presenters

Gala Martínez Bernal

Citation

Annals of Oncology (2017) 28 (suppl_5): v460-v496. 10.1093/annonc/mdx380

Authors

G. Martínez Bernal1, L. Mezquita2, E. Auclin3, R. Ferrara2, D. Planchard2, J. Remon Masip2, J. Lahmar2, M. Boucher2, C. CARAMELLA4, J. Adam5, A. Gazzah6, J. Soria6, B. Besse2

Author affiliations

  • 1 Medical Oncology, Hospital Universitario Virgen del Rocio, 41013 - Sevilla/ES
  • 2 Medical Oncology, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 3 Medical And Gastrointestinal Oncology, Hopital European George Pompidou, 75015 - Paris/FR
  • 4 Radiology, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 5 Pathology, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 6 Drug Development Department (ditep), Institut Gustave Roussy, 94800 - Villejuif/FR
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Resources

Abstract 3986

Background

Concomitant use of corticosteroids (CS) during immune checkpoint inhibitors (ICI) therapy are not recommended, but their real impact on ICI efficacy remains unknown. The aim of this study was to assess the impact of CS on ICI outcomes in NSCLC pts.

Methods

Baseline CS intake and dose, patient characteristics and outcome were retrospectively collected in patients treated with PD1/PDL1 inhibitors from Nov. 2012 to Mar. 2017 in our Institute. Primary endopoints were overall survival (OS) and disease control rate (DCR: complete response + partial response + stable disease) and secondary endpoint was progression free survival (PFS).

Results

We enrolled 244 pts. Median age was 63 years (30-85), 158 (65%) were males, 212 (87%) smokers, 196 (80%) PS 0-1; 155 (64%) had non-squamous cells carcinoma. The median of prior lines was 1 (0-11). KRASmut and EGFRmut was present in 62 (25%) and 14 (6%) of NSCLC, 3 (1%) were ALK+, 64 (26%) PDL1 + (cut-off 1% of tumor cells), 24 (10%) PD-L1- and 156 (64%) PD-L1 unknown. In the whole population, the overall response rate (ORR) was 20% and DCR 50%. Median OS and PFS were 9 months (m) [6-12] and 2m [2-3], respectively. The median follow-up was 10m [7-12]. Sixty-six patients (27%) received CS at baseline. Main reasons for taking CS were dyspnea (48%) and brain metastasis (15%). The median dose of daily prednisone was 16.25 mg [5;32.75] and >20mg in 19 (29%). CS dose >20mg was an independent factor for poor OS [HR 1,013, 95% CI 1,006; 1,02, p  20mg, the median OS was 3m [2-12] vs. 10m [7-15] for 20mg was 1m [1-4] vs. 3m [2-4] for < 20mg (p = 0.002). CS > 20mg was also significantly associated with progressive disease (p = 0.011).

Conclusions

Baseline daily prednisone intake of at least 20mg is associated with poor outcomes in advanced NSCLC treated with ICI. Further prospective studies are awaited for validating the real impact of CS in ICI efficacy.

Clinical trial identification

Legal entity responsible for the study

Dr Benjamin Besse

Funding

Institut Gustave Roussy

Disclosure

D. Planchard: AstraZeneca Boehringer Ingelheim BMS Lilly MSD Pfizer Roche Novartis Chugai. J-C. Soria: AstraZeneca, Astex, Clovis, GSK, Gammamabs, Lilly, MSD, Mission Therapeutics, Merus, Pfizer, Pharmamar Pierre Fabre, Roche-Genentech, Sanofi, Servier, Symphogen, Takeda. All other authors have declared no conflicts of interest.

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