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Poster session 04

1213P - Neoadjuvant tislelizumab (TIS) plus chemotherapy (CT) with adjuvant TIS vs. neoadjuvant placebo (PBO) plus CT with adjuvant PBO in resectable non-small cell lung cancer (NSCLC): patient-reported outcomes (PRO) in the RATIONALE-315 trial

Date

14 Sep 2024

Session

Poster session 04

Topics

Tumour Site

Non-Small Cell Lung Cancer

Presenters

Federico Cappuzzo

Citation

Annals of Oncology (2024) 35 (suppl_2): S775-S793. 10.1016/annonc/annonc1600

Authors

F. Cappuzzo1, C. Wang2, W. Wang3, H. Liu4, Q. Chen5, D. Yue2, S. Wang6, B. Yao7, B. Barnes8, G. Barnes8

Author affiliations

  • 1 Medical Oncology, Istituto Nazionale Tumori IRCCS Regina Elena, 00144 - Rome/IT
  • 2 Department Of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, 300060 - Tianjin/CN
  • 3 The Second Department Of Thoracic Surgery, Hunan Cancer Hospital, 410013 - Hunan/CN
  • 4 Department Of Thoracic Surgery, Liaoning Cancer Hospital and Institute, 110042 - Shenyang/CN
  • 5 Department Of Thoracic Surgery, Zhejiang Cancer Hospital, 310022 - Hangzhou/CN
  • 6 Clinical Development, BeiGene (Shanghai) Co., Ltd., 200020 - Shanghai/CN
  • 7 Clinical Development, BeiGene (Beijing) Co., Ltd, N/A - Beijing/CN
  • 8 Pro Research, BeiGene USA, Inc., 94404 - San Mateo/US

Resources

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Abstract 1213P

Background

In the pivotal phase III RATIONALE-315 trial (NCT04379635) of patients with resectable stage II to IIIA NSCLC, perioperative TIS plus (+) neoadjuvant platinum-based CT led to a significant improvement in event-free survival [HR=0.56, p=0.0003] compared to placebo + neoadjuvant platinum-based CT. Here, we report results for PRO instruments from RATIONALE-315.

Methods

PROs were secondary endpoints assessed using the EORTC QLQ-C30 and QLQ-LC13 instruments. Key PRO endpoints included QLQ-C30 GHS/QoL, physical function, as well as QLQ-LC13 symptoms of dyspnea, cough, and chest pain. A mixed model for repeated measures was performed at Cycle 1 (baseline), Cycle 3 of neoadjuvant phase, the Cycles 3 and 7 of adjuvant phase. Time to deterioration (TTD) was examined using Kaplan-Meier method. All HRQoL analysis were performed on the intent-to-treat analysis set.

Results

A total of 453 pts were randomized (1:1) to receive neoadjuvant TIS (n=226) or PBO (n=227). By Cycle 7, no meaningful differences in least-squares (LS) mean change from baseline between arms were observed for GHS/QoL, physical functioning, and fatigue, or chest pain and dyspnea (Table); however, the TIS + CT arm experienced a meaningful improvement in LS mean for coughing (-4.37 [95% CI: -9.46 to 0.21]). TTD analysis showed that pts in the TIS + CT arm were at lower risk of worsening for chest pain (HR 0.59 [95% CI: 0.38-0.91]); risk of worsening was similar between the arms in all other PRO endpoints. Table: 1213P

HRQoL endpoint Least squares mean (95% CI)
Cycle 3: Adjuvant phase Cycle 7: Adjuvant phase
TIS PBO TIS PBO
QLQ-C30
GHS/QoL -1.14 (-3.79, 1.52) -1.97 (-4.77, 0.83) 1.09 (-1.34, 3.53) 1.90 (-0.66, 4.46)
Physical functioning -3.57 (-5.10, -2.05) -3.61 (-5.22, -2.01) -2.60 (-4.20, 1.00) -2.23 (-3.92, -0.54)
Fatigue 2.52 (0.23, 4.81) 2.97 (0.57, 5.37) 2.54 (0.09, 4.99 2.87 (0.30, 5.45)
QLQ-LC13
Coughing -4.58 (-7.75, -1.42) -5.63 (-8.97, -2.29) -12.15 (-15.60, -8.71) -7.52 (-11.16, -3.89)
Chest pain 0.43 (-2.42, 3.28) 5.42 (2.39, 8.44) 0.36 (-2.34, 3.05) 1.89 (-0.96, 4.75)
Dyspnea 4.62 (2.57, 6.67) 6.57 (4.41, 8.74) 3.18 (0.82, 5.55) 4.56 (2.07, 7.06)

Conclusions

Pts in the TIS + chemo arm experienced better HRQoL outcomes than those in the PBO + CT arm in this population of patients with resectable NSCLC, with improvements in coughing and lower risk of chest pain.

Clinical trial identification

NCT04379635.

Editorial acknowledgement

Medical writing support, under the direction of the authors, was provided by Jason C. Allaire, PhD of Generativity Solutions Group, and was funded by BeiGene. Editorial and submission support was provided by Envision Pharma Inc., and funded by BeiGene.

Legal entity responsible for the study

BeiGene, Ltd.

Funding

BeiGene, Ltd.

Disclosure

F. Cappuzzo: Financial Interests, Personal, Advisory Board: Roche, AstraZeneca, BMS, Pfizer, Takeda, Lilly, Bayer, Amgen, Sanofi, Mirati, PharmaMar, Novocure, OSE, GALECTO and MSD; Financial Interests, Personal, Invited Speaker: Roche, AstraZeneca, BMS, Pfizer, Takeda, Lilly, Bayer, Amgen, Sanofi, PharmaMar, Mirati, Novocure, OSE, and MSD. S. Wang, B. Yao, G. Barnes: Financial Interests, Personal, Full or part-time Employment: BeiGene; Financial Interests, Personal, Stocks/Shares: BeiGene. B. Barnes: Financial Interests, Personal, Full or part-time Employment: BeiGene. All other authors have declared no conflicts of interest.

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