ESMO Congress 2024 | OncologyPRO

Abstract 1355P

Background

For stage IV NSCLC newly diagnosed patients without driver mutations, NICE recommends immune checkpoint inhibitors (ICI) as monotherapy or in combination with chemotherapy (chemo) for a maximum of 2 years, based on PD-L1 status. This study analyzed RW treatment patterns and outcomes, by PD-L1 status and after ICI discontinuation at 2 years.

Methods

NCRAS data on stage IV NSCLC pts diagnosed between 2019-2021 tested for PD-L1 status & receiving SACT treatments were analyzed. Overall survival (OS), time to next treatment/death (TTNTD), and time to treatment discontinuation/death (TTDD) stratified by PD-L1 status (high >50%, low 1-49%, negative <1%) were evaluated.

Results

From the analyzed data of 6100 NSCLC pts, 77% had a PD-L1 status available. PD-L1 high represented 38%, of which 68% were treated with ICI only. ICI+chemo was the most used in all other PD-L1 groups. Longer TTDD, TTNTD, OS were observed in ICI+chemo treated pts (Table), including PD-L1 high group. While a drop was observed in the TTDD curve around 24 months, indicating ICI therapy discontinuation, OS and TTNTD curves did not show an increase in death or in initiation of subsequent treatments.

Conclusions

Better outcomes were observed with ICI + chemo, including in the PD-L1 high cohort with a longer OS. ICI treatment discontinuation by 2 years did not seem to increase risk of progression or death. Table: 1355P

TTDD, TTNTD, and OS outcomes in high, low, and negative PD-L1 subgroups by treatment

PD-L1 status	ICI	ICI + chemo	Chemo (ie.PBC)
Tested	1290	1840	1390
High
N	1190	330	220
TTDD	5.32 [4.83, 5.72]	7.85 [6.67, 9.07]	2.14 [1.84, 2.76]
TTNTD	9.00 [8.21, 9.95]	11.63 [10.15,16.3]	5.13 [4.3, 5.91]
OS	12.32 [11.04,13.57]	17.91 [13.86, 23.56]	6.34 [5.16, 7.56]
Low
N	80	550	330
TTDD	3.45 [2.76, 5.39]	5.80 [5.29, 6.44]	2.76 [2.53, 2.76]
TTNTD	6.80 [4.57, 9.3]	10.68 [9.76,11.79]	5.98 [5.32, 6.6]
OS	8.87 [6.8, 11.47]	12.94 [11.47,14.78]	7.29 [6.18, 9.2]
Negative
N	20	960	840
TTDD	5.78 [3.45, 17.48]	5.68 [5.29, 6.21]	2.76 [2.76, 2.76]
TTNTD	6.51 [3.52, na]	9.07 [8.48, 9.72]	5.98 [5.72, 6.37]
OS	15.57 [6.51, na]	10.97 [10.15, 12.16]	7.59 [6.97, 8.38]

Median months [95% Conference Intervals]

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Sanofi.

Disclosure

F. Gomes: Non-Financial Interests, Institutional, Research Grant, Grant: Takeda, Pfizer, Gilead; Financial Interests, Institutional, Non remunerated activity, Honorarium: AstraZeneca, Takeda, Pfizer, Roche, Bristol-Myers, Servier, Boehringer Ingelheim, MSD, Sanofi. H. Lee: Financial Interests, Institutional, Other, Employee: IQVIA. F. Ingleby, E. Chaparova: Non-Financial Interests, Institutional, Other, Employee: IQVIA. I. Bouajila, P. Sudhapalli, Y. Zheng: Financial Interests, Institutional, Stocks/Shares, Employee: Sanofi.