2916 - Post progression survival for patients treated with docetaxel/nintedanib in the SENECA trial

Background

The SENECA trial showed similar progression free survival (PFS) and overall survival (OS) in non-squamous non-small cell lung cancer (nsNSCLC) patients (pts) treated with second-line docetaxel/nintedanib, regardless relapsing-time from end of first-line chemotherapy and docetaxel schedule employed (weekly or q3wks) [presented at AIOM 2018]. Because of the lack of data about optimal therapeutic algorithms for nsNSCLC pts and the evidence of a strong biologic rationale for using both antiangiogenic drugs and immunotherapy (IT), aim of the present analysis is to investigate post progression survival of SENECA pts, exploring if third-line IT may be positively influenced from prior nintedanib use.

Methods

SENECA enrolled 212 nsNSCLC pts treated with docetaxel and oral nintedanib, with the possibility of maintenance in case of stabilization or response. This evaluation focus on those 64 pts receiving a third-line treatment and aims to compare who underwent IT with the remaining ones. PFS2 and OS2 (time from start of docetaxel/nintedanib to progression during third-line or death, respectively) are investigated. Comparisons between Kaplan Meier curves of the two groups are made with Log Rank test. Hazard Ratios (HR) with 95% Confidence Interval (95%CI) are also reported.

Results

Pts treated with third-line (39 with IT, 25 with other agents) correspond to 30.2% of the entire study population; they were 40 males and 24 females, mainly current or former-smokers, with ECOG-performance status 0 in 79.7% of cases and average age of 62.2 years. At the cut-off date (April 29th, 2019), after 39.5 months follow-up, no significant differences appear between pts who received IT after SENECA progression and the other ones in terms of PFS2 (10.78 vs 7.91 months; HR 0.602 [95% CI 0.342-1.058], p-value=0.0821), while there are in terms of OS2 (14.33 vs 11.32 months; HR 0.537 [95% CI 0.292-0.987], p-value=0.0161).

Conclusions

Despite the small sample size, this analysis shows a higher post progression survival for nsNSCLC pts treated with docetaxel/nintedanib and third-line IT, postulating a synergism between the two regimens. Being this topic extremely attractive for development of new therapeutic algorithms, this report could be the basis for further investigations.

Clinical trial identification

EudraCT: 2014-005016-42.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Boehringer Ingelheim.

Disclosure

E. Capelletto: Advisory / Consultancy: Boehringer Ingelheim ; Advisory / Consultancy: AstraZeneca. A. Morabito: Honoraria (self): Roche; Honoraria (self): AstraZeneca; Honoraria (self): Boehringer Ingelheim; Honoraria (self): Pfizer; Honoraria (self): MSD; Honoraria (self): BMS. F. Grossi: Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Roche; Advisory / Consultancy: BMS; Advisory / Consultancy: MSD; Advisory / Consultancy: Celgene; Advisory / Consultancy: Eli Lilly; Advisory / Consultancy: Amgen. V. Scotti: Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Roche; Advisory / Consultancy: MSD; Advisory / Consultancy: BMS; Advisory / Consultancy: Pfizer; Advisory / Consultancy: Novartis; Advisory / Consultancy: Pierre Fabre. D. Galetta: Honoraria (self): Boehringer Ingelheim ; Honoraria (self): Roche; Honoraria (self): MSD. S. Novello: Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Roche; Advisory / Consultancy: Celgene; Advisory / Consultancy: Eli Lilly; Advisory / Consultancy: MSD; Advisory / Consultancy: BMS; Advisory / Consultancy: Takeda; Advisory / Consultancy: Pfizer; Advisory / Consultancy: AbbVie. All other authors have declared no conflicts of interest.