Abstract 2408
Background
The anti-tumor activity of Ctx after ICIs has been poorly investigated in patients with refractory advanced solid tumors. A recent communication suggested that ICIs may sensitize Non-Hodgkin Lymphoma to subsequent Ctx (Nicole A, Carreau et al, ASH 2019) but a control arm with exposure to alternative non-ICI therapy was missing.
Methods
From a prospective cohort of patients (pts) treated with ICIs (n = 310) or targeted agents (TAs) (n = 281) in Phase I trials at Vall d´Hebron Institute Oncology in the last 7 years, 31 (10.0%) and 52 (18.5%) received Ctx within 4 months after exposure to ICIs or TA, respectively. The aim of this study was to compare response rate (RR) and progression free survival (PFS) of subsequent Ctx after ICIs versus TAs. A propensity score (PS) matched analysis was performed to adjust for clinical-pathological heterogeneity between cohorts.
Results
In the overall study population, RR with Ctx after ICIs included partial response (PR) in 5 pts (16.1%), stable disease (SD) in 6 pts (16.4%) and progressive disease (PD) in 20 pts (64.5%). When Ctx was given after TAs, we found PR in 4 pts (7.7%), SD in 18 pts (34.6%) and PD in 30 (57.7%). Differences in RR with Ctx after ICIs or TAs were not significant (p = 0.43). Factors linked with higher RR were number of previous treatment lines (OR 0.51, p = 0.05) and breast cancer vs. other malignancies (OR 5.54, p = 0.05). In PS matched cohorts adjusted for these factors, median PFS with Ctx after ICIs was 2.3 months (95% IC 1.8-5.3) and after TAs was 3.2 months (95% CI 2.3-5.3; HR 1.01, 95% IC 0.59-1.74; p = 0.96).
Conclusions
Despite the numerically higher RR with Ctx after exposure to ICIs versus TAs (16.4% versus 7.7%), differences were not statistically significant and did not associate with improved median PFS after adjusting for clinico-pathological determinants of response to Ctx in advanced solid tumors. Larger prospectively designed cohorts are needed to validate this hypothesis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Vall d´Hebron Institute of Oncology (VHIO).
Funding
Has not received any funding.
Disclosure
J. Martin-Liberal: Speaker Bureau / Expert testimony: Astellas; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: BMS; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: MSD; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Novartis; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Pierre Fabre; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Pfizer; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Roche; Advisory / Consultancy: BMS; Travel / Accommodation / Expenses: ipsen. C. Hierro: Research grant / Funding (institution): Bayer; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Lilly; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Ignyta; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Roche. I. Brana: Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (self): BMS; Speaker Bureau / Expert testimony, Research grant / Funding (self), Travel / Accommodation / Expenses: Merck; Speaker Bureau / Expert testimony, Research grant / Funding (self), Travel / Accommodation / Expenses: AstraZeneca; Research grant / Funding (self): Celgene; Research grant / Funding (self): giknik; Research grant / Funding (self): GSK; Research grant / Funding (self): Janssen; Research grant / Funding (self): Kura; Honoraria (self): Novartis; Research grant / Funding (self): Orion; Research grant / Funding (institution): Pfizer. M. Vieito Villar: Travel / Accommodation / Expenses: Roche. C. Saura: Speaker Bureau / Expert testimony, .: Roche. T. Macarulla Mercade: Honoraria (self): Genzyme; Honoraria (self), Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Sanofi; Honoraria (self), Research grant / Funding (institution): Roche; Honoraria (self): Tesario; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Shire; Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (institution): Celgene; Advisory / Consultancy: QDE; Advisory / Consultancy, Travel / Accommodation / Expenses: H3B; Advisory / Consultancy: Baxalta; Research grant / Funding (institution): AstraZeneca; Research grant / Funding (institution): Agios; Research grant / Funding (institution): Aslan; Research grant / Funding (institution), Travel / Accommodation / Expenses: Bayer; Research grant / Funding (institution): Genentech. E. Muñoz-Couselo: Honoraria (self), Advisory / Consultancy: Amgen; Honoraria (institution), Advisory / Consultancy: BMS; Honoraria (self), Advisory / Consultancy: Dohme; Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: Pierre Fabre; Honoraria (self), Advisory / Consultancy: Roche. J. Tabernero: Honoraria (self), Josep Tabernero reports personal financial interest in form of scientific consultancy role for Array Biopharma, AstraZeneca, Bayer, BeiGene, Boehringer Ingelheim, Chugai, Genentech, Inc., Genmab A/S, Halozyme, Imugene Limited, Inflection Biosciences Limited, Ipsen, Kura Oncology, Lilly, MSD, Menarini, Merck Serono, Merrimack, Merus, Molecular Partners, Novartis, Peptomyc, Pfizer, Pharmacyclics, ProteoDesign SL, Rafael Pharmaceuticals, F. Hoffmann-La Roche Ltd, Sanofi, SeaGen, Seattle Genetics, Servier, Symphogen, Taiho, VCN Biosciences, Biocartis, Foundation Medicine, HalioDX SAS and Roche Diagnostics.: Josep Tabernero reports personal financial interest in form of scientific consultancy role for Array Biopharma, AstraZeneca, Bayer, BeiGene, Boehringer Ingelheim, Chugai, Genentech, Inc., Genmab A/S, Halozyme, Imugene Limited, Inflection Biosciences Limi. R. Dienstmann: Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche; Speaker Bureau / Expert testimony: Symphogen; Speaker Bureau / Expert testimony: Ipsen; Speaker Bureau / Expert testimony: Amgen; Speaker Bureau / Expert testimony: Sanofi; Speaker Bureau / Expert testimony: MSD; Speaker Bureau / Expert testimony: Servier; Research grant / Funding (self): Merck. E. Garralda: Advisory / Consultancy: Roche; Advisory / Consultancy: Ellipses Pharma ; Advisory / Consultancy: Neomed; Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: Janssen Global Services; Speaker Bureau / Expert testimony: BMS; Travel / Accommodation / Expenses: Merck; Travel / Accommodation / Expenses: Glycotope; Travel / Accommodation / Expenses: Menarini. All other authors have declared no conflicts of interest.
Resources from the same session
5877 - Efficacy of anti-PD(L)1 treatment in patients with metastatic urothelial cancer based on mRNA- and protein- based PD-L1 determination: Results from the multicentric, retrospective FOsMIC trial
Presenter: Jonas Jarczyk
Session: Poster Display session 3
Resources:
Abstract
5204 - A differential bladder microbiota composition is associated with tumor grade in bladder cancer.
Presenter: Monica Parra-Grande
Session: Poster Display session 3
Resources:
Abstract
4904 - Molecular characterization of metastatic urothelial carcinoma (mUC) in prior or current smokers (PCS) vs non-smokers (NS)
Presenter: Victor Sacristan Santos
Session: Poster Display session 3
Resources:
Abstract
5370 - Evaluation of different diagnostic methods for identification of FGFR alteration in advanced urothelial carcinomas: Proficiency Results based on multiple RNA extraction kits and mutation detection methods
Presenter: Veronika Weyerer
Session: Poster Display session 3
Resources:
Abstract
2579 - Title: Genomic characterization of non-schistosomiasis-related squamous cell carcinoma (NSR-SCC) of the urinary bladder: a retrospective study of potential prognostic and predictive biomarkers
Presenter: Esmail Al-ezzi
Session: Poster Display session 3
Resources:
Abstract
2203 - TiNivo: Tivozanib combined with nivolumab results in prolonged progression free survival in patients with metastatic renal cell carcinoma (mRCC). Final Results.
Presenter: Philippe Barthelemy
Session: Poster Display session 3
Resources:
Abstract
4712 - First-Line Pembrolizumab (pembro) Monotherapy for Advanced Non‒Clear Cell Renal Cell Carcinoma (nccRCC): Updated Follow-Up for KEYNOTE-427 Cohort B
Presenter: Cristina Suárez
Session: Poster Display session 3
Resources:
Abstract
2091 - First-Line Pembrolizumab (pembro) Monotherapy in Advanced Clear Cell Renal Cell Carcinoma (ccRCC): Updated Follow-Up For KEYNOTE-427 Cohort A
Presenter: James Larkin
Session: Poster Display session 3
Resources:
Abstract
2368 - Association Between Depth of Response and Overall Survival: Exploratory Analysis in Patients With Previously Untreated Advanced Renal Cell Carcinoma (aRCC) in CheckMate 214
Presenter: Viktor Grünwald
Session: Poster Display session 3
Resources:
Abstract
6008 - Quality of life in previously untreated patients with advanced renal cell carcinoma (aRCC) in CheckMate 214: updated results
Presenter: David Cella
Session: Poster Display session 3
Resources:
Abstract