76P - Immune checkpoint inhibitor (ICI) retreatment patterns and outcomes in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) who received second-line or later (2L+) nivolumab (nivo): A French I-O Optimise analysis

Background

While ICIs demonstrate improved clinical trial outcomes in patients with NSCLC, little is known about real-world ICI retreatment patterns and outcomes after 2L+ nivo therapy. This analysis aimed to understand these endpoints in a real-world patient group in France.

Methods

Patients with locally advanced/metastatic NSCLC who initiated 2L+ nivo from 2015–2020 were included from ESME-AMLC, a retrospective observational cohort involving 39 centres in France (NCT03848052). Patient demographics, clinical and retreatment characteristics and outcomes were determined. Patients were followed from 2L+ nivo start date to last medical information date. Retreatment patterns were defined as: rechallenge (any ICI following an intervening non-ICI anticancer treatment after 2L+ nivo discontinuation); resumption (any ICI post-treatment break >6 weeks), ICI switch (any non-nivo ICI post-treatment break <6 weeks).

Results

After a median follow-up of 24 weeks, 2985/4001 (74.6%) patients discontinued 2L+ nivo treatment, 1604 received chemotherapy (CT) or targeted therapy (40.1%), 800 (20%) had no further treatment, and 226 (7.6%) were retreated with ICI. Of these: 110 (48.7%) were rechallenged (median treatment duration 2.1 months), 102 (45.1%) resumed (median treatment duration 3.3 months), and 14 (6.2%) switched ICI. Most patients retreated with ICI had non-squamous histology (80 [72.7%] patients with rechallenge, 76 [74.5%] with resumption, and 12 [85.7%] with ICI switch). Median duration of initial nivo treatment was 5.5 months for rechallenge, 7 months for resumption and 7 months for ICI switch. Median overall survival (OS) from retreatment date was 16.6 months vs 8.3 months for patients who resumed or were rechallenged. Patients who received initial 2L+ nivo for >26 weeks had higher ICI retreatment rates (15.8% overall) than patients who received 2L+ nivo for <13 weeks (3.6% overall).

Conclusions

Following 2L+ nivo discontinuation, most patients received CT. Few received ICI retreatment, although this increased with 2L+ nivo duration. Patients resuming ICI had longer OS than those with rechallenge.

Clinical trial identification

NCT03848052.

Editorial acknowledgement

Medical writing support was provided by Latitude (Powered by AXON).

Legal entity responsible for the study

Bristol Myers Squibb.

Funding

Bristol Myers Squibb.

Disclosure

G. Justeau: Non-Financial Interests, Personal, Advisory Role: BMS. M. Pérol: Financial Interests, Personal, Advisory Board: Roche, AstraZeneca, MSD, BMS, Lilly, Novartis, Takeda, Gritstone, Sanofi, Pfizer, Amgen, Janssen, GSK, Eisai, Ipsen; Financial Interests, Personal, Invited Speaker: Roche, AstraZeneca, MSD, BMS, Boehringer Ingelheim, Takeda, Illumina, Pfizer, Medscape; Financial Interests, Institutional, Research Grant: AstraZeneca, Roche, Takeda, Boehringer Ingelheim; Financial Interests, Personal, Steering Committee Member: Roche; Financial Interests, Personal, Other, DMSB: Roche. C. Audigier Valette: Financial Interests, Personal, Advisory Board: Roche, BMS, MSD, AstraZeneca, Sanofi, Janssen; Financial Interests, Personal, Invited Speaker: Pfizer. D. Debieuvre: Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, MSD, Janssen, Pfizer, OSE Immunotherapeutics, Novartis, SanofiAventis, Amgen, Roche, Ipsen; Financial Interests, Personal, Invited Speaker: Gilead, Takeda; Financial Interests, Personal, Coordinating PI: Pfizer; Financial Interests, Institutional, Funding: Roche, AstraZeneca, Janssen, MSD, Pfizer, BMS, Lilly, Boehringer Ingelheim, GSK, Chugaï, Chiesi, Novartis, Takeda, Bayer, SanofiAventis. X. Quantin: Financial Interests, Institutional, Invited Speaker: Sanofi; Financial Interests, Institutional, Advisory Board: BMS; Financial Interests, Institutional, Other, Educational support: AstraZeneca. H. Lena: Non-Financial Interests, Personal, Research Funding: Bristol Myers Squibb; Non-Financial Interests, Personal, Coordinating PI: Regeneron Pharmaceuticals, Sanofi Aventis, GSK, Pfizer; Financial Interests, Personal, Advisory Board: Sanofi Aventis, Pfizer, Takeda, Roche, Amgen. P. Macouillard: Financial Interests, Institutional, Full or part-time Employment: Unicancer. L. Bosquet: Financial Interests, Institutional, Full or part-time Employment, In charge of scientific projects at Unicancer, Health Data and Partnership Department: Unicancer. M.J. Schoemaker, M. Mella, B. Correia: Financial Interests, Personal, Full or part-time Employment: IQVIA. C. Rault: Financial Interests, Personal, Speaker, Consultant, Advisor: Bristol Myers Squibb; Financial Interests, Personal, Full or part-time Employment: Data Gnosis. M.J. Daumont: Financial Interests, Personal, Full or part-time Employment: Bristol Myers Squibb; Financial Interests, Personal, Stocks or ownership: Bristol Myers Squibb. J. Penrod: Financial Interests, Personal, Full or part-time Employment: Bristol Myers Squibb; Financial Interests, Personal, Stocks or ownership: Bristol Myers Squibb. C. Chouaid: Financial Interests, Personal, Advisory Board: AZ, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen and Amgen; Financial Interests, Institutional, Funding: AZ, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen and Amgen.