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
4242 - HIV, HBV and HCV screening practices in oncology: a cross-sectional interregional survey
Presenter: Isabelle Poizot-Martin
Session: Poster Display session 1
Resources:
Abstract
1267 - Genetic landscape of KEAP1 and NFE2L2 mutated cancers from the AACR GENIE database
Presenter: Mark Zaki
Session: Poster Display session 1
Resources:
Abstract
878 - β-arrestin1 is involved in the Ras-induced malignant transformation
Presenter: Takashi Shibano
Session: Poster Display session 1
Resources:
Abstract
4143 - Incidence of second cancer among PLWHIV: retrospective observational study of a series of 601 patients in the French CANCERVIH network
Presenter: Jean-Philippe Spano
Session: Poster Display session 1
Resources:
Abstract
5145 - A challenging task – Identifying carcinoma of unknown primary (CUP) patients according to ESMO guidelines: the CUPISCO trial experience
Presenter: Chantal Pauli
Session: Poster Display session 1
Resources:
Abstract
1737 - Incidence and Outcome of chronic lymphocytic leukemia with Deletion 17p: An Indian experience; challenges and opportunities
Presenter: Ajay Gogia
Session: Poster Display session 1
Resources:
Abstract
2596 - Driving solo? Investigation into collaborating mutations in SDH-deficient neoplasia
Presenter: Jonathan Killian
Session: Poster Display session 1
Resources:
Abstract
1499 - The potential of a novel antiangiogenic VEGFR1-D2 binding peptide in oncology therapeutics
Presenter: Afsaneh Sadre Momtaz
Session: Poster Display session 1
Resources:
Abstract
1775 - First-in-human phase I study of TAS-117, an allosteric AKT inhibitor, in patients with advanced solid tumors
Presenter: Mayu Yunokawa
Session: Poster Display session 1
Resources:
Abstract
4584 - First-in-human study of ABBV-621 in patients (pts) with previously treated sold tumors: Dose-optimization cohorts
Presenter: Emiliano Calvo
Session: Poster Display session 1
Resources:
Abstract