Abstract 5736
Background
Patients with mNSCLC benefit in terms PFS and OS of treatment with immunotherapy (IO) in first (1L) and second line (2L); However, the majority of patients do not respond to IO, which, due to the high cost of these new treatments, makes identifying predictive factors of response imperative in order to select the patients who will really respond to this therapy. Bearing in mind that most hospitals do not have the technology to perform high sensitivity techniques such as NGS, it seems prudent to be able to identify these patients using more common, cheap and affordable methods in any hospital.
Methods
In all mNSCLC treated with IO in monotherapy in two university hospitals in Spain, from February 2012 to January 2018, a RWD study of predictive factors of response was performed. 198 patients from the University Hospital Arnau de Vilanova of Lleida and the University Hospital Dr. Josep Trueta (ICO Girona) were analyzed. Statistical analysis of the data was performed using IBM SPSS Statistics 23.0 software.
Results
With a median follow-up from the start of treatment with IO of 217 days, it was found that in all treated patients, the overall response rate (ORR = CR + PR) was 26.6%. In 1L the ORR was 56%, in 2L 22.8%, in 3L 15% and in 4L 0%. In 1L, the factor that is associated with a better response is the absence of liver mets: ORR 66.7% vs 16.7% (p: 0.03). The factor associated with a better OS is Hb ≥ 12.5 gr/dl (p 0.001): 495 vs 241 days. Analyzing by treatment lines, we objectify that in 1L, the factors that influence better OS are the absence of liver mets (p 0.003): 421 (CI: 345-497) vs 138 days (CI: 65-212) ) and Hb ≥ 12.5gr dl (p 0.027) 440 (CI: 368-512) vs 215 days (CI: 111-319). In 2L the factors that influence a better OS are younger age with a cutoff point of 70 years (p 0.008): 328 vs 239 days; Hb ≥ 12.5 gr/dl (p 0.001): 512 vs 325 days and lymphocytes > 1450 (p 0.013): 353 vs 241 days.
Conclusions
Methods that are easily available in any hospital can help select the patients that benefit most from immunotherapy in monotherapy. In our series, patients older than 70 years, with Hb ≤ 12.5 gr/dl and lymphocytes ≤1.450, have worse overall survival independently of PDL1.
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
4543 - Long-term real-world (RW) outcomes in patients with advanced melanoma (MEL) treated with ipilimumab (IPI) and non-IPI therapies: IMAGE study
Presenter: Stéphane Dalle
Session: Poster Display session 3
Resources:
Abstract
4523 - Prognostic Factors for efficacy of Ipilimumab used after AntiPD1 and/or BRAF+MEK inhibitors in Melanoma Patients: an Italian Melanoma Intergroup study
Presenter: Riccardo Marconcini
Session: Poster Display session 3
Resources:
Abstract
3632 - Rechallenge with combination ipilimumab and anti-PD-1 (IPI+PD1) in metastatic melanoma after acquired resistance to IPI+PD1 immunotherapy
Presenter: Adriana Hepner
Session: Poster Display session 3
Resources:
Abstract
3732 - Clinicopathologic characteristics of immune colitis in melanoma patients treated with combination ipilimumab and anti-PD1 (IPI+PD1) and PD1 monotherapy.
Presenter: Kazi Nahar
Session: Poster Display session 3
Resources:
Abstract
5005 - Real-world outcomes of ipilimumab plus nivolumab for advanced melanoma in the Netherlands
Presenter: Michiel van Zeijl
Session: Poster Display session 3
Resources:
Abstract
5524 - Utilization of Real-World Data to Assess the Effectiveness of Immune Checkpoint Inhibitors (ICIs) in Elderly Patients with Metastatic Melanoma
Presenter: D Scott Ernst
Session: Poster Display session 3
Resources:
Abstract
5884 - Tumor mutational burden and response to PD-1 inhibitors: an analysis of 89 cases of metastatic melanoma.
Presenter: Léa Dousset
Session: Poster Display session 3
Resources:
Abstract
3120 - Increase in S100B and LDH as early outcome predictors for non-responsiveness to anti-PD-1 monotherapy in advanced melanoma.
Presenter: Elisa Rozeman
Session: Poster Display session 3
Resources:
Abstract
2157 - Immune status defined by molecular information layers predicts response to pembrolizumab treatment in advanced melanoma
Presenter: Guillermo Prado-Vázquez
Session: Poster Display session 3
Resources:
Abstract
2553 - Interim analysis of a phase Ib study of cobimetinib plus atezolizumab in patients with advanced BRAFV600 wild type melanoma progressing on prior anti-PD-L1 therapy
Presenter: Shahneen Sandhu
Session: Poster Display session 3
Resources:
Abstract