Abstract 3368
Background
First-line therapy with pembrolizumab is the standard of care in locally advanced and metastatic non-small cell lung cancer (NSCLC) with a PD-L1 expression of ≥ 50%. However, efficacy results in patients with a PS ≥ 2, untreated brain metastases or permanent oral steroids are lacking.
Methods
Patients from six certified lung cancer centers in Berlin, Germany, presenting with stage III (non resectable, not suitable for chemoradiation) and IV NSCLC, with a PD-L1 expression of ≥ 50%, diagnosed or treated between January 1st, 2017 and December 31, 2017 were included in this retrospective study. Progression-free (PFS) and overall survival (OS) were calculated using the Kaplan-Meier method. Cox regression analyses were used to identify prognostic factors for survival. Values are given as median (range).
Results
During the observation period, 128 patients fulfilled the inclusion criteria. Median age was 68.6 years (39 – 85), 76 patients were male (59.4%). Histology was predominantly non-squamous (68.8%). 31 patients (24.2%) had an initial PS of ≥ 2. Oral steroids for ≥2 weeks (equivalent daily doses of ≥ 10 mg of prednisolone during therapy with pembrolizumab) were prescribed to 34 patients (26.6%). Pembrolizumab was initiated in 24 patients with previously untreated brain metastases (18.8%). Within a follow-up of 13.0 months (95% CI, 10.5 – 15.4), a median of 9 cycles (1 – 38) were administered corresponding to a duration of treatment of 6.9 months (95% CI, 4.6 – 9.2). Therapy was still ongoing in 30 patients (23.4%). PFS was 9.4 months (95% CI, 4.8 – 14.1) with a duration of response of 11.9 months (95%CI, 8.4 – 15.4). OS reached 18.9 months (95% CI, NE – NE). A PS ≥ 2 was associated with a reduced OS (HR 0.43, 95% CI, 0.25 – 0.75, p = 0.003), no effects were noted for brain metastases and steroids.
Conclusions
Our data from real life practice in an all comer population demonstrate the efficacy of pembrolizumab in NSCLC with a PD-L1 expression of ≥ 50%. Despite a reduced survival in PS ≥ 2, the reached OS of 8.0 months is superior to historic cohorts with cytotoxic chemotherapy. Furthermore, OS was unchanged in case of untreated brain metastases or permanent steroids.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5054 - Inhibition of Rspo-Wnt pathway Facilitates Checkpoint Blockade Therapy by anti-RSPO3 antibody (DBPR117)
Presenter: John Hsu
Session: Poster Display session 1
Resources:
Abstract
3305 - A phase I dose-escalation and expansion trial of intratumorally administered CV8102, alone and in combination with anti-PD-1 in patients with advanced solid tumors
Presenter: Jürgen Krauss
Session: Poster Display session 1
Resources:
Abstract
5353 - Phase 1/2 Study of 9-ING-41, a small molecule selective Glycogen Synthase Kinase-3 Beta (GSK-3β) Inhibitor, as a Single Agent and Combined with Chemotherapy, in Patients with Refractory Hematological Malignancies or Solid Tumors
Presenter: Benedito Carneiro
Session: Poster Display session 1
Resources:
Abstract
3946 - Trial in progress: a Phase I, open-label study of GSK1795091 administered in combination with immunotherapies in participants with advanced solid tumors (NCT03447314).
Presenter: Aaron Hansen
Session: Poster Display session 1
Resources:
Abstract
3449 - Radiographic Phenotyping to Identify Intracranial Disseminated Recurrence in Brain metastases Treated With Radiosurgery Using Contrast-enhanced MR Imaging
Presenter: CheYu Hsu
Session: Poster Display session 1
Resources:
Abstract
4553 - Association between TP53 mutations and efficacy of Osimertinib for brain metastasis from EGFR-mutant lung cancer
Presenter: Lijuan Chen
Session: Poster Display session 1
Resources:
Abstract
4942 - Response assessment of melanoma brain metastases treated by stereotactic radiotherapy or immunotherapy or both: a comparison of RECIST 1.1, RANO and iRANO criteria
Presenter: Emilie Le Rhun
Session: Poster Display session 1
Resources:
Abstract
3529 - Management of multiple brain metastases by Staged SRS focusing on utmost risk lesions
Presenter: shaoqun Li
Session: Poster Display session 1
Resources:
Abstract
5315 - Whole brain radiotherapy plus simultaneous in-field boost versus whole brain radiotherapy plus fractionated stereotactic radiotherapy for multiple brain metastases of non-small cell lung cancer
Presenter: Lu Li
Session: Poster Display session 1
Resources:
Abstract
1116 - 3D based texture analysis serving as potential diagnostic factor in discriminating primary central nervous system lymphoma from metastatic brain tumors: A preliminary study
Presenter: Wen Guo
Session: Poster Display session 1
Resources:
Abstract