Abstract 4882
Background
Anti-PD1 immunotherapy has emerged as a gold-standard treatment in stage IV non-small cell lung cancer (NSCLC). Despite long-term disease control in 5-20% of patients, secondary resistance often occurs. Local ablative treatment (LAT) and treatment beyond progression for oligo-progressive disease may improve long-term outcomes in stage IV non-small cell lung cancer after tumor response to anti-PD1 treatment.
Methods
In this retrospective multicentric cohort study, stage IV NSCLC patients treated with LAT for oligo-progression after initial tumor response to anti-PD1 were identified using electronic medical records from 3 centers. Here are reported clinical characteristics and outcomes of 27 patients. Quantitative data were summarized as median. Survival was estimated using Kaplan-Meier method.
Results
Twenty-seven patients received 31 LAT with surgery (n = 3, 10%), stereotactic radiotherapy (n = 18, 58%) or conformational radiotherapy (n = 10, 32%) after nivolumab (n = 19, 70%) or pembrolizumab (n = 8, 30%) treatment. Patients received anti-PD1 treatment in first (n = 3, 11%), second (n = 18, 67%) or third-line (n = 6,22 %) for stage IV NSCLC (adenocarcinoma/ squamous/not-otherwise specified: 18/8/1; PDL1 not evaluated/negative/1-49/>50: 10/8/1/6). Oligo-progression site was: brain (n = 19, 61%), lung (n = 5, 16%), adrenal gland (n = 2, 6%) and bone (n = 4, 13%). Anti-PD1 treatment was continued beyond progression after LAT in 22 (81%) patients. Oligo-progression occurred 6.9 months after anti-PD1 initiation. Progression Free Survival (PFS) after oligo-progression was 13.1 months (IC95: 7.0-not reached). Nine (33%) patients experienced ≥1 grade ≥2 immune adverse event before LAT. One patient had grade 3 toxicity after LAT (cerebral radionecrosis). Overall survival was not mature after a median follow-up of 9.1 months from LAT. Data will be updated before presentation and subgroup analysis will be presented.
Conclusions
LAT and treatment beyond progression for oligo-progression after initial tumor response to anti-PD1 treatment provide encouraging survival outcomes in selected stage IV NSCLC patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
F. Guisier: Honoraria (self), Advisory / Consultancy: BMS; Honoraria (institution), Advisory / Consultancy: MSD / Merck US; Honoraria (self), Advisory / Consultancy: Roche; Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (institution): Boehringer Ingelheim. R. Gervais: Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self), Advisory / Consultancy: Roche; Honoraria (self), Advisory / Consultancy: Boehringer Ingelheim. M. Geier: Honoraria (self): BMS; Honoraria (self): MSD / Merck US. R. Corre: Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: BMS; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Roche; Travel / Accommodation / Expenses: MSD / Merck US. R. Descourt: Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self), Advisory / Consultancy: Boehringer Ingelheim; Honoraria (self), Advisory / Consultancy: Roche. C. Chouaid: Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: BMS; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: MSD / Merck US; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: Roche; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: AstraZeneca. All other authors have declared no conflicts of interest.
Resources from the same session
3309 - Heat Shock Protein 90 chaperones and Protein Kinase D3 regulates androgen-independent prostate cancer development
Presenter: Attila Varga
Session: Poster Display session 1
Resources:
Abstract
3441 - The SWI/SNF driven reprograming for the AR cistrome is NSD2 dependent
Presenter: Katia Ruggero
Session: Poster Display session 1
Resources:
Abstract
1659 - IGF1R inhibition affects the survival of HT29 cancer cells by alterations of the TLR9- and autophagy signaling
Presenter: Györgyi Műzes
Session: Poster Display session 1
Resources:
Abstract
1379 - Characterization of atypical dMMR (deficient MisMatch Repair) tumors: a study from a large cohort of 4948 cases
Presenter: Marion Jaffrelot
Session: Poster Display session 1
Resources:
Abstract
1657 - Modulation of TLR9-dependent autophagy response via inhibition of c-Met signaling influences the survival of HT29 cancer cells
Presenter: Ferenc Sipos
Session: Poster Display session 1
Resources:
Abstract
3045 - Positive Feedback Activation of Notch Signal by Obesity Enhances Colorectal Tumorigenicity
Presenter: Dake Chu
Session: Poster Display session 1
Resources:
Abstract
2285 - The Pathological and Functional Roles of BRPF1 in Hepatocellular Carcinoma
Presenter: Lai Hung Carol Cheng
Session: Poster Display session 1
Resources:
Abstract
3210 - Protein tyrosine phosphatase non-receptor type 3 (PTPN3) could be a new therapeutic target for pancreatic cancer.
Presenter: Akio Yamasaki
Session: Poster Display session 1
Resources:
Abstract
3920 - A Novel bispecific BCMAxCD3 T cell engaging antibody that treat multiple myeloma (MM) with minimal cytokine serection
Presenter: Zhenyu Li
Session: Poster Display session 1
Resources:
Abstract
2691 - Quantitative spatial profiling of lymphocyte-activation gene 3 (LAG-3)/major histocompatibility complex class II (MHC II) interaction in gastric and urothelial tumors
Presenter: Cyrus Hedvat
Session: Poster Display session 1
Resources:
Abstract