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
3157 - Efficacy and safety of anlotinib in advanced leiomyosarcoma: Subgroup analysis of a phase IIB trial (ALTER0203)
Presenter: Yihebali Chi
Session: Poster Display session 1
Resources:
Abstract
3710 - The effect of treatment line on the efficacy of Anlotinib hydrochloride in advanced alveolar soft part sarcoma patients
Presenter: Zhiwei Fang
Session: Poster Display session 1
Resources:
Abstract
3184 - Prior exposure to pazopanib (PAZ) did not minor efficacy of regorafenib (REG) in non-adipocytic soft tissue sarcoma patients (pts)
Presenter: Nicolas Penel
Session: Poster Display session 1
Resources:
Abstract
798 - Pexidartinib (Pex) for locally advanced tenosynovial giant cell tumor (TGCT): characterization of hepatic adverse reactions (ARs)
Presenter: Sebastian Bauer
Session: Poster Display session 1
Resources:
Abstract
6117 - VEGFR2 and ITGA polymorphisms as novel pan-sarcoma biomarkers for sensitivity prediction as well as toxicity prevention anti-angiogenesis therapy in pediatric and young adult
Presenter: Qiyuan Bao
Session: Poster Display session 1
Resources:
Abstract
5450 - Reversion of resistance to mTOR inhibitors with the addition of exemestane in patients with malignant PEComa.
Presenter: Roberta Sanfilippo
Session: Poster Display session 1
Resources:
Abstract
4279 - Efficacy and Safety of VEGFR2 Inhibitor Apatinib combined with chemotherapy for Sarcoma in Stage IV
Presenter: Zhiwu Ren
Session: Poster Display session 1
Resources:
Abstract
5929 - Outcomes of metastatic soft tissue sarcoma treated with Pazopanib from dedicated medical oncology sarcoma clinic: A holistic care approach from a developing country
Presenter: Akhil Kapoor
Session: Poster Display session 1
Resources:
Abstract
2469 - Inhibition of mTOR signaling enhances Trabectedin activity in Soft Tissue Sarcoma
Presenter: David Moura
Session: Poster Display session 1
Resources:
Abstract
4210 - Efficacy and safety of apatinib for advanced gastrointestinal stromal tumors after failure of imatinib and sunitinib: An open-label, multicenter, single-arm, phase II trial
Presenter: Zhaolun Cai
Session: Poster Display session 1
Resources:
Abstract