Abstract 1084
Background
Immune checkpoint inhibitors (ICI) have been demonstrated to improve overall survival (OS) in several cancer types. Atypical patterns of response have been reported including durable responses, pseudoprogression and hyperprogression. We evaluated the occurrence of dissociated response (DR) on immunotherapy.
Methods
We retrieved all patients treated at the Curie Institute with an ICI either alone or in combination with another ICI in the frame of a clinical trial. Patients had to have a baseline CT-scan and at least one follow-up CT-scan, and at least two target lesions (TLs). There was no selection on tumor type. All TLs on CT-scans were assessed by two independent readers according to RECIST 1.1. Three types of DR were evaluated: 1) one TL in partial or complete response (CR/PR) and one progressive TL (DR1), 2) one stable TL and one progressive TL (DR2), and 3) one TL in CR/PR and one stable TL (DR3). Finally, we evaluated the impact of previous radiotherapy and biopsy on TLs on the occurrence of DRs.
Results
1,246 measures of 272 TLs were performed in the 100 patients who met our inclusion criteria. The median number of TLs per patient was 3 [range: 2-5]. 49 out of the 272 TLs (18%) had received prior radiotherapy, and 38 (14%) had been biopsied. Median progression-free survival (PFS) was 3.8 months. Median OS was 13.4 months. Best overall response per patient was a PR/CR in 22%, stable disease (SD) in 33% and progressive disease (PD) in 45%. Best overall response on 272 TLs was a PR/CR in 52 TLs (19%), SD in 142 TLs (52%) and PD in 78 TLs (29%). DR1 were observed in 8% of patients, whereas DR2 and DR3 were observed in 44% and 10% of patients, respectively. While prior irradiation on TLs did not correlate with the occurrence of DRs, DRs were more common when one TL was biopsied ORa = 2.22 (1.28, 3.86) (p = 0.004).
Conclusions
DR with a responding TL and a progressive TL according to RECIST1.1 was observed in 8% of patients. While prior irradiation on TLs did not correlate with the occurrence of DRs, DRs were more common when one TL was biopsied.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
D. Loirat: Advisory / Consultancy, Travel / Accommodation / Expenses: MSD; Advisory / Consultancy: Novartis; Honoraria (institution), Travel / Accommodation / Expenses: Roche; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy, Travel / Accommodation / Expenses: BMS; Advisory / Consultancy: Pfizer. C. Le Tourneau: Advisory / Consultancy: MSD; Advisory / Consultancy: BMS; Advisory / Consultancy: Amgen; Advisory / Consultancy: Merck; Advisory / Consultancy: Serono; Advisory / Consultancy: Roche; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Nanobiotix; Advisory / Consultancy: GSK. All other authors have declared no conflicts of interest.
Resources from the same session
2600 - Atezolizumab (atezo) vs chemotherapy (chemo) in patients (pts) with platinum-treated locally advanced or metastatic urothelial carcinoma (mUC): a long-term overall survival (OS) and safety update from the Phase III IMvigor211 study
Presenter: Michiel Van der Heijden
Session: Poster Display session 3
Resources:
Abstract
3598 - Three-Year Follow-Up From the Phase 3 KEYNOTE-045 Trial: Pembrolizumab (Pembro) Versus Investigator’s Choice (Paclitaxel, Docetaxel, or Vinflunine) in Recurrent, Advanced Urothelial Cancer (UC)
Presenter: Andrea Necchi
Session: Poster Display session 3
Resources:
Abstract
2382 - First Report of Efficacy and Safety From a Phase 2 Trial of Tislelizumab, an Anti-PD-1 Antibody, for the Treatment of PD-L1+ Locally Advanced or Metastatic Urothelial Carcinoma (UC) in Asian Patients
Presenter: Dingwei Ye
Session: Poster Display session 3
Resources:
Abstract
2388 - Quality of Life of Metastatic Urothelial Cancer (mUC) Patients Treated with Enfortumab Vedotin (EV) Following Platinum-Containing Chemotherapy and a Checkpoint Inhibitor (CPI): Data from EV-201 Cohort 1
Presenter: Bradley McGregor
Session: Poster Display session 3
Resources:
Abstract
3748 - Safety and efficacy of atezolizumab (atezo) in patients (pts) with autoimmune disease (AID): subgroup analysis of the SAUL study in locally advanced/metastatic urinary tract carcinoma
Presenter: Yohann Loriot
Session: Poster Display session 3
Resources:
Abstract
1126 - Validation of the VIO prognostic index in patients with metastatic urothelial carcinoma treated with immune-checkpoint inhibitors
Presenter: Rafael Morales Barrera
Session: Poster Display session 3
Resources:
Abstract
3693 - Pathologic outcomes after neoadjuvant chemotherapy for high-risk muscle invasive bladder cancer
Presenter: Justin Matulay
Session: Poster Display session 3
Resources:
Abstract
4840 - Analysis of response to prior therapies and therapies after treatment with erdafitinib in fibroblast growth factor receptor (FGFR)-positive patients (pts) with metastatic urothelial carcinoma (mUC)
Presenter: Arlene Siefker-Radtke
Session: Poster Display session 3
Resources:
Abstract
1221 - Clinical outcomes by sex with atezolizumab (atezo) monotherapy in patients (pts) with locally advanced/metastatic urothelial carcinoma (mUC)
Presenter: Jean Hoffman-censits
Session: Poster Display session 3
Resources:
Abstract
1715 - National Small Cell Bladder Cancer Audit: Results from 26 UK institutions
Presenter: Caroline Chau
Session: Poster Display session 3
Resources:
Abstract