Abstract 3628
Background
Pembrolizumab monotherapy improved overall survival (OS), progression free survival (PFS) and response rate compared to chemotherapy in patients with treatment-naïve advanced NSCLC with high PD-L1 expression ( > =50%), but we see in daily clinical practice that not all patients in this subgroup benefit equally. Prognostic and predictive factors and tools are needed.
Methods
Multicentric retrospective review of advanced NSCLC patients with high PD-L1 treated with frontline pembrolizumab from March 2015 to April 2019 was performed in 19 Spanish hospitals. We analyzed the prognostic value of different clinical variables and Lung Immune Prognostic Index (LIPI), and selected those who were prognostic in the univariate analysis. Multivariate Cox regression models were adjusted to evaluate the adequacy of models, C-index was used (values over 0.7 indicate a good model, and values over 0.8 indicate a strong model.
Results
223 patients were included. Mean age 67 years (SD 9.8). 77.6% were male and 75% PS < =1. Predominant histologies: adenocarcinoma (65%), squamous-cell carcinoma (26%). Median PFS was 12.8 months (CI95%;9.8-15.9). Median OS was not reached (24 month-OS 53.6%). LIPI 2 subgroup (unadjusted HR 3,77;p<0,001), female sex (HR 1,76; p = 0,034), age under 60 (HR 1,74; p = 0,039), presence of > =2 metastatic locations (HR 2,74;p<0,001), basal haemoglobin level < =12g/dl (HR 2; p = 0,005), corticoids use (HR 5,31;p<0,001) and ECOG-PS (HR 5,43;p<0,01) were included in a predictive Cox regression model, with a predictive C-index of 0.812 for OS and 0.76 for PFS, suggesting good discrimination. OS predictive model was called LIPI-FAMACE: LIPI - F(emale) A(ge) M(etastatic locations) A(nemia) C(orticoid use) E(COG).
Conclusions
LIPI-FAMACE model has a good capability for predicting survival in patients with advanced NSCLC and high PD-L1 expression treated with frontline pembrolizumab. This model needs prospective validation in an independent prospective cohort.
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
3664 - Longitudinal changes in cell-free DNA (cfDNA) methylation levels identify early non-responders to treatment in advanced solid tumors
Presenter: Andrew Davis
Session: Poster Display session 3
Resources:
Abstract
3212 - Multigene panel testing results for hereditary breast cancer in 1325 individuals: implications for gene selection and considerations for guidelines.
Presenter: Georgios Tsaousis
Session: Poster Display session 3
Resources:
Abstract
2591 - PIK3R5 genetic predictors of hypertension induced by VEGF-pathway inhibitors
Presenter: Julia Quintanilha
Session: Poster Display session 3
Resources:
Abstract
4377 - ERBB2 mRNA as a predictor in HER2-positive (HER2+)/hormone receptor-positive (HR+) metastatic breast cancer (BC) treated with HER2 blockade in combination with endocrine therapy (ET): a retrospective analysis of the ALTERNATIVE and SOLTI-PAMELA trials.
Presenter: Nuria Chic
Session: Poster Display session 3
Resources:
Abstract
3439 - Early on-treatment vs pre-treatment tumor transcriptomes as predictors of response to neoadjuvant therapy for HER2-positive inflammatory breast cancer
Presenter: Sonia Pernas
Session: Poster Display session 3
Resources:
Abstract
2512 - AXL expression predicts poor prognosis and lack of efficacy of anti-angiogenic and anti-epidermal growth factor receptor (EGFR) agents in patients (pts) with RAS wild type (WT) metastatic colorectal cancer (mCRC)
Presenter: Claudia Cardone
Session: Poster Display session 3
Resources:
Abstract
4061 - Prevalence of EGFR mutations and its correlation with Egyptian patients’ human kinetics (PEEK Study)
Presenter: Adel Ibrahim
Session: Poster Display session 3
Resources:
Abstract
2547 - Evaluation of tumor microenvironment identifies immune correlates of response to combination immunotherapy with margetuximab (M) and pembrolizumab (P) in HER2+ gastroesophageal adenocarcinoma (GEA)
Presenter: Sergio Rutella
Session: Poster Display session 3
Resources:
Abstract
4671 - Clinicopathological and molecular criteria assessment for the screening of hypermutated proficient mismatch repair (pMMR) colorectal cancers (CRC) with exonucleasic domain POLE (edPOLE) mutations (mt).
Presenter: Benoit Rousseau
Session: Poster Display session 3
Resources:
Abstract
3862 - Tumor mutation burden and microsatellite instability in colorectal cancer
Presenter: Francesca Fenizia
Session: Poster Display session 3
Resources:
Abstract