Abstract 1112P
Background
Real-world (RW) evidence on tx patterns and clinical outcomes in pts with METex14 aNSCLC stratified by programmed death-ligand 1 (PD-L1) expression remains scarce.
Methods
Pts with METex14 aNSCLC who received ≥1 systemic therapy were selected from the de-identified Flatiron Health-Foundation Medicine NSCLC Clinico-Genomic Database from January 2011 to December 2019. The de-identified data originated from approximately 280 US cancer clinics (∼800 sites of care). Demographics, baseline characteristics, tx patterns and the clinical outcomes were described by PD-L1 status [tumor proportion score (TPS) ≥50% (PD-L1 high), TPS 1% - 49% (PD-L1 low), TPS <1% (PD-L1 negative), and unknown] in RW pts.
Results
Of the 93 pts included in the study, 81 (87%) had 1L tx since 2016, with 29 (31%) PD-L1 high, 10 (11%) PD-L1 low, 15 (16%) PD-L1 negative and 39 (42%) PD-L1 unknown. All patients with known PD-L1 status initiated 1L tx in or after 2016. Key baseline characteristics across four PD-L1 groups were: age ≥75 years (41%, 40%, 40%, 74%), squamous cell histology (3%, 10%, 7%, 13%), smoking history (76%, 70%, 67%, 56%), and stage IV NSCLC at initial diagnosis (59%, 70%, 53%, 62%), respectively. The most common 1L tx in high PD-L1 group was immuno-oncology (IO) monotherapy (11/29; 38%) and IO + chemotherapy (CT) in low PD-L1 group (5/10; 50%). 1L CT use was 27%, 40%, 47% and 51% in PD-L1 high, low, negative and unknown groups, respectively. Crizotinib use was limited across all subgroups. Pts with high PD-L1, especially those receiving 1L IO, had numerically lower median RW PFS than other groups. Table: 1112P
| RW PFSb, months | OS, months | |||
| na | Median (95% CI) | n | Median (95% CI) | |
| All pts | 87 | 4.6 (3.7-5.9) | 93 | 11.5 (7.7-20.0) |
| PD-L1 high | ||||
| Overall | 26 | 3.4 (1.9-5.6) | 29 | 26.2 (7.0-NR) |
| IO or IO + CT 1L | 15 | 2.4 (1.4-5.1) | 15 | NR (2.6-NR) |
| Other SOC 1L | 11 | 4.5 (1.9-8.6) | 14 | 12.0 (3.5-NR) |
| PD-L1 low | 10 | 4.7 (0.0-NR) | 10 | 10.9 (0.0-NR) |
| PD-L1 negative | 15 | 6.6 (1.8-7.8) | 15 | 7.8 (2.4-13.3) |
| Unknown | 36 | 5.6 (3.9-8.1) | 39 | 10.0 (6.2-22.7) |
a87 pts had real-world progression assessment; bReal-world progression assessed as part of routine clinical care (physician’s interpretation of radiology reports abstracted from clinic visit notes; decision based on radiology and/or clinical assessment) NR=Not reached; SOC=standard of care
Conclusions
This study provides insights into tx and outcomes of pts with METex14 in view of observed PD-L1 status. Due to sample size limitation, clinical outcomes observed in this study should be further validated in larger cohorts and in pts receiving newer generation MET inhibitors.
Clinical trial identification
Editorial acknowledgement
The authors thank ManojKumar Patel, Novartis Healthcare Pvt. Ltd. for providing medical writing and editorial support.
Legal entity responsible for the study
Novartis Pharmaceuticals Corporation.
Funding
Novartis Pharmaceuticals Corporation.
Disclosure
N. Leighl: Financial Interests, Personal, Other, CME/independent lectures: MSD, BMS, Hoffmann LaRoche, EMD Serono; Financial Interests, Personal, Invited Speaker, independent lectures: Novartis, Takeda; Financial Interests, Personal, Advisory Board: Puma Biotechnology; Financial Interests, Institutional, Research Grant: Amgen, AstraZeneca, Array, Bayer, EMD Serono, Guardant Health, Lilly, MSD, Pfizer, Roche, Takeda. M. Hampe: Financial Interests, Personal, Full or part-time Employment: Novartis. W. Wu, J. Kim: Other, Personal, Advisory Role: Novartis. V. Pretre, F. Ye: Financial Interests, Personal, Full or part-time Employment: Novartis; Financial Interests, Personal, Stocks/Shares: Novartis.