1353P - Efficacy and safety of docetaxel in combination with nintedanib or ramucirumab following immune checkpoint-Inhibitor treatment in patients with non-small cell lung cancer

Background

The combination of docetaxel with nintedanib (D+N) or ramucirumab (D+R) is the standard of care for the second- or third- line therapy after simultaneous or sequential chemoimmunotherapy for patients (pts) with non-small cell lung cancer (NSCLC) without targetable molecular alterations. The combinations of D+N or D+R. were tested and approved before the immune checkpoint-inhibitors (ICI) became first-line treatment. Particularly, data about the safety of D+N or D+R after ICI treatment are limited.

Methods

Retrospective data were collected from 5 German cancer centers and practices. Only pts who had received at least 1 cycle of docetaxel with nintedanib (D+N) or ramucirumab (D+R) after a therapy that involved ICI were included. The number of cycles, progression-free survival (PFS) and overall survival (OS), objective response rate (ORR) and adverse events (AEs) resulting in therapy discontinuation were assessed for all pts.

Results

173 pts were retrospectively recruited. Of them, 115 pts (66.5%) had an adenocarcinoma (ADC), 47 pts (27.2%) a squamous cell carcinoma and 5 pts (2.9%) a large cell neuroendocrine carcinoma. 61 pts (35.3%) received D+N, 112 pts (64.7%) received D+R. To 69 pts (39.9%) docetaxel-based therapy (D+N or D+R) was administered as second-line, to 76 pts (43.9%) as third-line and to 28 pts (16.2%) as further line. ORR induced by D+N was 44.3% (27 pts), while it was 41.1% (73) achieved by D+R. A median of 6 induction and 5 maintenance cycles of D+N were administered compared to 3 induction and 4 maintenance cycles of D+R. 16 pts (27.1%) with D+N had a dose reduction, while 43 pts (53.7 %) with D+R were treated with a reduced dose. Median OS of all pts was 8.7 months. Focussing on ADC pts (105 pts), 60 pts (52%) received D+N and 55 pts (48%) D+R. Median OS was 9.5 months for D+N and 6.8 months for D+R, but the difference was not statistically significant (p=0.16). Median OS of all ADC pts was 7.2 months.

Conclusions

In ADC pts the efficacy of D+N or D+R after chemoimmunotherapy was not significantly different. Docetaxel dose was reduced more often during D+R therapy. 20% of all pts had to stop therapy prematurely due to AEs.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

D.C. Christoph: Financial Interests, Personal, Speaker, Consultant, Advisor: AstraZeneca, Boehringer-Ingelheim, Bristol Myers Squibb, Chugai, Ipsen, Merck, MSD Sharp & Dohme, Novocure, Novartis, Pierre Fabre, Pfizer, Roche, Sanofi, Takeda. All other authors have declared no conflicts of interest.