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
2831 - Interleukin-6 as a Predictive Marker for Early Response to Induction Chemotherapy in Acute Myeloblastic Leukaemia
Presenter: Salah Khallaf
Session: Poster Display session 1
Resources:
Abstract
6014 - Impact of FLT3-ITD mutation on post-transplant outcome of adult AML is modified by the concomitant NPM1 mutation and pre-transplant remission status: A report from Taiwan Bone Marrow Transplant Registry (TBMTR)
Presenter: Su-peng Yeh
Session: Poster Display session 1
Resources:
Abstract
2914 - Efficacy endpoints studied in clinical trials for early-onset leukaemia
Presenter: Dylan Said
Session: Poster Display session 1
Resources:
Abstract
4691 - High triglyceride is a major risk factor of DIC and differentiation syndrome in acute promyelocytic leukemia
Presenter: Tomohiro Yamakawa
Session: Poster Display session 1
Resources:
Abstract
4395 - DREAMM 4: A Phase I/II single-arm open-label study to explore safety and clinical activity of belantamab mafodotin (GSK2857916) administered in combination with pembrolizumab in patients with relapsed/refractory multiple myeloma (RRMM)
Presenter: Suzanne Trudel
Session: Poster Display session 1
Resources:
Abstract
2808 - A Phase 1 Study of HMPL-523, a Selective Oral Anti-Spleen Tyrosine Kinase Inhibitor, in Patients with Relapsed or Refractory Lymphoma
Presenter: Nathan Fowler
Session: Poster Display session 1
Resources:
Abstract
4403 - A Phase 1 Study of HMPL-689, a Selective Oral Phosphoinositide 3-Kinase-Delta Inhibitor, in Patients with Relapsed or Refractory Lymphoma
Presenter: Jonathon Cohen
Session: Poster Display session 1
Resources:
Abstract
3357 - A global patient-driven Facebook study in a very rare sarcoma: Health-related quality of life in Epithelioid Hemangioendothelioma (EHE) patients
Presenter: Marije Weidema
Session: Poster Display session 1
Resources:
Abstract
2475 - Qualitative study of patients’ experiences of living with and beyond a soft tissue sarcoma diagnosis: the impact of sarcoma specialist services
Presenter: Ana Martins
Session: Poster Display session 1
Resources:
Abstract
2640 - Health-related quality of life issues of patients affected by desmoid-type fibromatosis; experiences from two countries
Presenter: Milea Timbergen
Session: Poster Display session 1
Resources:
Abstract