Abstract 1128P
Background
Immunotherapy has improved the clinical outcomes of patients with advanced non-small cell lung cancer (NSCLC) and has become the standard of care. However, its superior efficacy on the advanced NSCLC with Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation needs to be further verified in real-world practice. This study aimed to explore its efficacy in a Chinese cohort.
Methods
In this retrospective study, clinical, molecular and pathologic data were extracted from the electronic health records of patients with advanced NSCLC between January 2018 and November 2020 at Shandong Cancer Hospital and Institute. Progression-free survival and overall survival for the patients in the cohort were evaluated.
Results
A total of 793 patients with stage IIIB-IV NSCLC were identified, of which 123 patients with KRAS mutation were finally included for analysis. These patients included 98 (79.7%) with stage IV disease and 115 (93.6%) with adenocarcinoma. 31% (38/123) patients received anti-PD-(L)1 therapy with or without chemotherapy, while 69% (85/123) patients received chemotherapy. The median OS of these patients was 25.2 months (95% CI: 12.97–37.50) and the median PFS was 9.8 months (95% CI: 6.46–13.21). Patients receiving immunotherapy were found to have better mOS than those who received chemotherapy (45.2 vs. 13.5 months, P=0.001), while the mPFS was not statistically different (8.8 vs. 12.3 months, P=0.916). Further analysis indicated that the mOS were significantly improved by immunotherapy either in the first-line setting (P=0.027) or the second plus the third-line settings (P=0.011) compared with chemotherapy. Subgroup analyses for patients with anti-PD-(L)1 therapy with chemotherapy, anti-PD-(L)1 therapy only, chemotherapy plus anti-angiogenic therapy, or chemotherapy alone indicated that the longest mOS was achieved by anti-PD-(L)1 therapy combined with chemotherapy (NR vs. 45 months vs. 16 months vs. 13 months, LogRank test P=0.007), but not the longest mPFS (LogRank test P=0.115).
Conclusions
Immunotherapy seemed to achieve longer OS than chemotherapy for patients with KRAS-mutant advanced NSCLC independently of line settings. Anti-PD-(L)1 in combination with chemotherapy tends to produce the largest survival benefit.
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.