Abstract 1314P
Background
The potential effect of the sequential combination of chemotherapy and immune checkpoint inhibitors (ICI) remains unclear. We evaluated the efficacy of different chemotherapy regimens administered after ICI in advanced non-small cell lung cancer (NSCLC), compared to the same regimens administered without previous ICI.
Methods
We retrospectively included all patients (pts) treated between 2015 and 2019 for an advanced NSCLC, receiving a salvage chemotherapy just after ICI (CAI group), comparing them to ICI naive patients (INP group) undergoing the same chemotherapy at Bordeaux University Hospital.The primary outcome was the time to treatment discontinuation (TTD), and secondary endpoints were overall survival (OS) from the first day of chemotherapy to death and overall response rate (ORR).
Results
153 pts were included, with 34/23 (CAI/INP) receiving paclitaxel/bevacizumab (PB), 24/11 paclitaxel (P), 28/12 gemcitabine (G) and 6/15 pemetrexed (PE). Age and ECOG PS did not vary significantly between CAI and INP regardless of the chemotherapy regimen except for CAI treated with PB (more pts with an ECOG PS ≤ 1 (p<0.001)). Median line number was higher in CAI for all groups. There was no difference between CAI and INP in terms of TTD, OS and ORR for all groups. However, OS tended to increase in CAI treated with PB (HR=0.65; 95%CI 0.38-1.2, p=0.17, Table]. ORR were not significantly different between CAI and INP for all the chemotherapy groups.
Conclusions
Our data showed no difference in TTD, OS and ORR regardless of chemotherapy, but there was a trend to an increased OS with PB when given after ICI, whereas pts received chemotherapy later in the CAI group. This suggests that a sequential combination of ICI followed by chemotherapy could be an interesting strategy in advanced NSCLC for some pts. However, the place of such therapeutic strategy has to be determined since combinations are validated as first-line treatment. Table: 1314P
| mTTD (months) | mOS (months) | ORR (%) | ||
| Paclitaxel-Bevacizumab (PB) | CAI (n=34) | 5.5 | 18.3 | 43 |
| INP (n=23) | 3.3 | 6.6 | 39 | |
| Paclitaxel (P) | CAI (n=24) | 1.45 | 4.5 | 24 |
| INP (n=11) | 2.8 | 5.8 | 10 | |
| Pemetrexed (PE) | CAI (n=6) | 2.25 | 8.6 | 33 |
| INP (n=15) | 1.4 | 3.8 | 18 | |
| Gemcitabine (G) | CAI (n=27) | 1.6 | 5.7 | 18 |
| INP (n=12) | 1.5 | 4.05 | 10 |
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Bordeaux University Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.