Abstract 2066
Background
1L IO mono tx for advanced NSCLC is an option based on recent clinical trials. As there are few data regarding tx sequencing following 1L IO mono tx for NSCLC, there is interest in seeking evidence to identify optimal tx sequences in this setting. This analysis explored 2L systemic tx and overall survival (OS) in pts with NSCLC following 1L IO mono tx in a real-world setting.
Methods
A retrospective analysis of 2604 randomly selected pts with advanced (stage IIIB/IV) NSCLC treated in US practices (156 community and 3 academic sites) between Jan 2013 and Dec 2018 was conducted using the Flatiron Health EHR-derived database. Tx regimens were defined using only therapies initiated in the first 30 days of tx. 1L tx was defined as tx received prior to disease progression (PD); 2L tx was defined as first tx after first PD. 2L tx patterns and OS were assessed in pts treated with 1L IO mono tx. OS and 95% CIs were calculated using Kaplan-Meier (KM) methods.
Results
Pts treated with 1L IO mono tx (initiated after 01 Jan 2016) at each site were identified in the database (N = 105). 91 pts were eligible for the initial exploratory analysis (platinum-based doublet/triplet, n = 35; single-agent chemo, n = 26; IO ± chemo, n = 15; other, n = 15; Table). A multivariable-adjusted KM analysis of 2L OS revealed longer survival with platinum-based doublet/triplet (24.4 months) vs IO ± chemo (17.9 months), other (11.6 months), and single-agent chemo (4.7 months).Table:
1497P Adjusted 2L OS in pts treated with 1L IO mono Tx
Treatment Group | Events/Total, N/N | OS, Median (95% CI), months |
---|---|---|
Platinum-based doublet/triplet | 13/35 | 24.4 (10.6-24.4) |
IO ± cytotoxic chemo | 7/15 | 17.9 (4.9-17.9) |
Othera | 11/15 | 11.6 (5.3-NE) |
Single-agent cytotoxic chemo | 19/26 | 4.7 (3.0-14.7) |
NE, not estimable.
aIncludes targeted mono tx/doublets, chemo/monoclonal antibody doublets, chemo doublets, and clinical study drugs.
Conclusions
Although the longest survival was in the platinum-based cohort, the unknown tx strategy for 1L IO mono tx and a small sample size limit the generalizability of the data. The hypothesis-generating result suggests further research on the efficacy of 2L platinum therapy after 1L IO tx is needed. Additional analyses of complementary real-world data in an NSCLC population treated with IO in the 1L are planned.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Celgene.
Disclosure
S.M. Fish: Full / Part-time employment: Celgene. T. Jin Ong: Full / Part-time employment: Celgene. E.D. Flick: Full / Part-time employment: Celgene. D.M. Waterhouse: Advisory / Consultancy: AbbVie; Advisory / Consultancy: Amgen; Advisory / Consultancy: AZ; Advisory / Consultancy: BMS. All other authors have declared no conflicts of interest.
Resources from the same session
1851 - Nivolumab-induced and radiation recall pneumonitis in patients with non-small cell lung cancer: a multicenter real world analysis of 669 patients
Presenter: Nobuaki Mamesaya
Session: Poster Display session 1
Resources:
Abstract
851 - Retrospective analysis of immunotherapy prognostic scores in advanced NSCLC at Nottingham University Hospitals (UK)
Presenter: Cristina Lopez Escola
Session: Poster Display session 1
Resources:
Abstract
3639 - Applicability of lung immune prognostic index (LIPI) to predict efficacy of first-line pembrolizumab in advanced non-small-cell lung cancer (NSCLC)
Presenter: Xabier Mielgo Rubio
Session: Poster Display session 1
Resources:
Abstract
2950 - Delayed Onset Immune Related Adverse Effects (IRAEs) of Pembrolizumab in Non-Small Cell Lung Cancer
Presenter: Haixi Yan
Session: Poster Display session 1
Resources:
Abstract
3659 - Clinical implication of multiplex IHC and serologic biomarkers on Hyperprogression in NSCLC patients receiving Immune checkpoint blockers in real world.
Presenter: Joori Kim
Session: Poster Display session 1
Resources:
Abstract
4882 - Local ablative treatment and treatment beyond progression for oligo-progression in stage IV non-small cell lung cancer after tumor response to anti-PD1 treatment
Presenter: Florian Guisier
Session: Poster Display session 1
Resources:
Abstract
1358 - Atezolizumab in combination with chemotherapy for first-line treatment of advanced non-small cell lung cancer: A systematic review and meta-analysis of randomized controlled trials (RCTs)
Presenter: Francis Mogollon-Duffo
Session: Poster Display session 1
Resources:
Abstract
2170 - Prognostic Impact of Metastatic Sites for Pembrolizumab Efficacy as First-line therapy in Patients with PD-L1 tumor proportion score (TPS) ≥ 50% Advanced Non–Small Cell Lung Cancer: A Retrospective Multicenter Study
Presenter: Hayato Kawachi
Session: Poster Display session 1
Resources:
Abstract
3051 - Impact of visceral fat area as independent predictive factor in patients with advanced non-small cell lung cancer treated with nivolumab
Presenter: Yuki Sato
Session: Poster Display session 1
Resources:
Abstract
3409 - Effect and safety of immune checkpoint inhibitors for brain metastases from non-small cell lung cancer
Presenter: Toshihiko Iuchi
Session: Poster Display session 1
Resources:
Abstract