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
4925 - Prognostic role of CD73 in metastatic Non Small Cell Lung Cancer according to the presence of driver alterations
Presenter: Giulia Galli
Session: Poster Display session 1
Resources:
Abstract
785 - JAK-STAT inhibitor overcomes interferon γ-reduced, NK cell-mediated cytotoxicity in non-small-cell lung cancer cells
Presenter: Riki Okita
Session: Poster Display session 1
Resources:
Abstract
2326 - Low LATS2 expression is associated with poor prognosis in non small cell lung cancer
Presenter: Si-hyong Jang
Session: Poster Display session 1
Resources:
Abstract
5960 - Application of ESCAT and OncoKB scales in Liquid biopsy (LB) in Advanced NSCLC patients (pts): Is it feasible and reliable?
Presenter: Michael McCusker
Session: Poster Display session 1
Resources:
Abstract
4855 - IDH1R132H mutation induces a less aggressive phenotype of glioma cells and affects the radiosensitivity by interacting with Wnt/β-catenin signaling
Presenter: Xuetao Han
Session: Poster Display session 1
Resources:
Abstract
2641 - Impact of Angiopoietin-2 on glioblastoma response to combined chemo-radiotherapy
Presenter: Charly Helaine
Session: Poster Display session 1
Resources:
Abstract
5743 - The Discovery of RNA-aptamers That Selectively Bind and Inhibit Glioblastoma Stem Cells by targeting EphA2
Presenter: Alessandra Affinito
Session: Poster Display session 1
Resources:
Abstract
4160 - Impact of tumor reoxygenation by nanoparticles on Tumor Associated Macrophages (TAMs)
Presenter: Aurélie Ferré
Session: Poster Display session 1
Resources:
Abstract
2474 - Prognostic significance of c-Rel/p50 heterodimer in the tumor microenvironment of uveal melanoma
Presenter: Seema Kashyap
Session: Poster Display session 1
Resources:
Abstract
1769 - Synergistic role of BAP1 and DNA damage response pathway in uveal melanoma and its prognostic significance.
Presenter: JAYANTI JHA
Session: Poster Display session 1
Resources:
Abstract