333P - Efficacy and safety of immune checkpoint inhibitors alone or combined with chemotherapy in pulmonary sarcomatoid carcinoma

Background

Pulmonary sarcomatoid carcinoma (PSC) is a rare subtype of lung cancer, associated with a worse prognosis and resistance to platinum-based chemotherapy. Immune checkpoint inhibitors (ICI) alone or in combination with chemotherapy are the standard of care for non-small cell lung cancer, yet the benefit of ICI in patients with PSC remains unclear.

Methods

This multicenter retrospective study evaluated patients with advanced or recurrent PSC treated with ICI included therapy between Dec 2015 and Sep 2021. Patients were divided into three cohorts: cohort A (ICI plus chemotherapy as first-line therapy), cohort B (ICI as first-line therapy), and cohort C (ICI as second- or later-line therapy). Clinical efficacy and immune-related adverse events (irAEs) were evaluated.

Results

A total of 124 patients were included. The patients’ characteristics were as follows: male/female, 97/27; median age (range), 69 (35-84); PS 0-1/≥2, 103/21; advanced/recurrent, 76/48. Most patients had pleomorphic carcinoma (n = 92, 74.2%) and tumor PD-L1 expression ≥50% (n = 81, 65.3%). The overall response rate (ORR), median progression-free survival (PFS), and median overall survival (OS) were 59.0%, 10.5 months, and 32.8 months, respectively. Similar results were observed regardless of tumor PD-L1 expression. The PFS and OS rates at 24 months were 35.3% and 51.5%. There was no significant difference in the ORR, PFS, or OS between the three cohorts (Table). IrAEs were observed in 67 patients (54.0%), including 27 patients (21.8%) with grade 3-5 events. Patients with grade 1-2 irAEs showed higher ORR, longer PFS and OS than those with no irAEs or grade 3-5 irAEs. Table: 333P

Conclusions

ICI therapy for PSC showed promising efficacy regardless of the treatment line and PD-L1 expression.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

H. Kaneda: Financial Interests, Personal, Speaker’s Bureau: Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., MSD K.K., Ono Pharmaceutical Co., Ltd., Bristol Myers Squibb Co. Ltd., Pfizer, Novartis pharm, Nippon Boehringer Ingelheim Co., Ltd., Taiho Pharmaceutical Co., Ltd.; Financial Interests, Personal, Funding: Eli Lilly Japan K.K. H. Kodama: Financial Interests, Personal, Speaker’s Bureau: Chugai Pharmaceutical Co. Ltd, Boehringer Ingelheim. A. Miyazaki: Financial Interests, Institutional, Research Grant: ONO Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., MSD K.K., Delta-Fly Pharma, Inc. K. Azuma: Financial Interests, Personal, Invited Speaker: AstraZeneca, Bristol Myers Squibb, Ono Pharmaceutical, Takeda Pharmaceutical, Chugai Pharmaceutical, Pfizer, MSD. Y. Kawashima: Financial Interests, Personal, Speaker’s Bureau: Eli Lilly and Company, Chugai Pharmaceutical, Taiho Pharmaceutical, AstraZeneca. Y. Sato: Financial Interests, Personal, Speaker’s Bureau: AstraZeneca, MSD, Novartis, Chugai Pharmaceutical, Ono Pharmaceutical, Pfizer, Taiho Pharmaceutical, Nippon Kayaku, Bristol Myers Squibb, Eli Lilly, Takeda, Kyowa Kirin. K. Ito: Financial Interests, Personal, Speaker’s Bureau: Eli Lilly, Takeda Pharmaceutical, Boehringer Ingelheim, Chugai Pharmaceutical, MSD, Taiho Pharmaceutical, AstraZeneca, Ono Pharmaceutical, Pfizer. Y. Shiraishi: Financial Interests, Personal, Invited Speaker: Chugai Pharma, Ono Pharmaceutical, Bristol Myers Squibb Company, AstraZeneca, Taiho Pharmaceutical; Non-Financial Interests, Personal, Principal Investigator: Chugai Pharma. K. Miura: Financial Interests, Personal, Invited Speaker: Chugai Pharmaceutical, Taiho Pharmaceutical. S. Oizumi: Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Institutional, Research Grant: AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Chugai Pharmaceutical, MSD, Pfizer, Sanofi, Taiho Pharmaceutical, Takeda Pharmaceutical. Y. Namba: Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb, AstraZeneca, Chugai pharmaceutical, Boehringer Ingelheim; Financial Interests, Institutional, Invited Speaker: MSD, Abbvie. S. Ikeda: Financial Interests, Personal, Invited Speaker: AstraZeneca, Chugai, Bristol Myers Squibb, Ono, Taiho, Eli Lilly, Pfizer, Boehringer Ingelheim. S. Miura: Financial Interests, Personal, Invited Speaker: Chugai Pharmaceutical, Taiho Pharmaceutical, Ono Pharmaceutical, AstraZeneca, Bristol Myers Squibb, Eli Lilly, Boehringer Ingelheim Japan, Pfizer, Novartis, MSD, Kyowa Hakko Kirin, Daiichi Sankyo, AbbVie, Nippon Kayaku, Amgen, Merck, Takeda Pharmaceutical. M. Tachihara: Financial Interests, Personal, Invited Speaker: Eli Lilly Japan K.K., Chugai Pharmaceutical Co.,Ltd., AstraZeneca K.K, MSD K.K., Ono Pharmaceutical Co.,Ltd., Bristol Myers Squibb Co. Ltd.; Financial Interests, Personal and Institutional, Research Grant: AstraZeneca K.K. All other authors have declared no conflicts of interest.