70P - Efficacy of PD-1 blockade plus chemotherapy in patients with oncogenic-driven non-small cell lung cancer

Background

PD-1 blockade combined with chemotherapy has become the standard of care for patients with advanced non-small-cell lung cancer (NSCLC) without oncogenic drivers. Oncogenic-driven advanced NSCLC showed limited response to PD-1 blockade monotherapy or chemotherapy alone. Whether NSCLC patients with oncogenic drivers showed response to PD-1 blockade plus chemotherapy remains undetermined.

Methods

329 patients with at least one oncogenic driver alteration NSCLC receiving PD-1 plus chemotherapy or each monotherapy were retrospectively identified. Objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were used to evaluate the therapeutic outcomes differences among patients with different oncogenic drivers.

Results

Totally, 176 patients received PD-1 blockade plus chemotherapy, 60 patients received PD-1 blockade monotherapy and 93 patients received chemotherapy alone were included. Oncogenic drivers including KRAS (31.0%), EGFR (30.4%), HER2 (14.6%), BRAF (10.3%), RET (7.0%) and other mutations (6.7%) were identified. Compared with PD-1 and chemo mono-treatment, patients with oncogenic drivers received PD-1 blockade plus chemotherapy showed significantly better objective response rate (48% vs 22% and 26%; P < 0.001), progression-free survival (median 9.5 vs 3.8 and 5.6 months; P < 0.001) and overall survival (median 25.3 vs 16.8 and 17.0 months; P < 0.001). Multivariate cox regression analysis revealed that PD-1 blockade plus chemotherapy showed dramatically improved benefits both in PFS and OS.

Conclusions

PD-1 blockade plus chemotherapy showed superior efficacy than PD-1 blockade monotherapy or chemotherapy alone in patients with oncogenic-driven advanced NSCLC, particularly in KRAS, EGFR and BRAF subgroup, indicating that PD-1 blockade plus chemotherapy could be considered as optional treatments when these patients without available targeted therapy.

Legal entity responsible for the study

The authors.

Funding

This study was supported in part by grants from the National Natural Science Foundation of China (Nos.82102859, 82172869, 82141101, 82272875 and 12126605).

Disclosure

All authors have declared no conflicts of interest.