Abstract 55P
Background
First-line treatment of advanced NSCLC has undergone a great change in recent years. The aim of MOREL is to describe patterns of clinical management of newly diagnosed stage IV NSCLC pts without targetable mutations and to characterize PD-L1 testing in Spain.
Methods
This is a multicenter, observational, retrospective study based on clinical records from 10 representative centers. Pts diagnosed in 2019 with stage IV NSCLC and no sensitizing mutations/translocations (EGFR, ALK, BRAF, ROS1) were included. Clinical management and PD-L1 diagnosis methods are described, according to demographic and clinicopathologic characteristics of the population.
Results
Two hundred ninety-seven patients were included. Overall, median age was 67 years (range: 37-89), 77.1% were male. ECOG 0, 1 or ≥2 was 27.8%, 46.4%, and 25.8%, respectively. 17.8 % had squamous NSCLC. 15.2% and 21.9% had liver and brain metastases, respectively. Data on autoimmune disease, comorbidities and systemic corticosteroids was also analyzed. PD-L1 test was performed in 287 pts (96.6%), 4.9% in centralized laboratory, with a median turnaround time of 5 days. The most used method was 22C3 pharmaDx kit (54.7%). PD-L1 TPS (<1%, 1-49% and ≥50%) account for 40.1%, 26.8%, and 32.1%, respectively. Table: 55P
| N | Double CT (Chemotherapy) | Single agent CT | IO | CT + IO | IO + IO |
| % | |||||
| Overall treated population 265 | 53.6 | 1.9 | 26.8 | 14.7 | 2.3 |
| Age groups | |||||
| ≤75 years 218 | 54.1 | 1.4 | 24.3 | 17 | 2.3 |
| >75 years 47 | 51.1 | 4.3 | 38.3 | 4.3 | 2.1 |
| Gender | |||||
| Male 204 | 55.9 | 2 | 27 | 12.7 | 2 |
| Female 61 | 45.9 | 1.6 | 26.2 | 21.3 | 3.3 |
| Smoking history | |||||
| Current/former smoker 236 | 54.7 | 1.7 | 26.7 | 14 | 2.1 |
| Never smoked 26 | 38.5 | 3.8 | 30.8 | 23.1 | 3.8 |
| ECOG | |||||
| 0-1 209 | 52.2 | 1 | 25.8 | 17.2 | 2.9 |
| ≥2 54 | 61.1 | 5.6 | 27.8 | 5.6 | 0 |
| NSCLC histological subtype | |||||
| Squamous 50 | 68 | 2 | 24 | 2 | 4 |
| Non squamous 215 | 49.8 | 1.9 | 27.4 | 17.7 | 2.3 |
| Brain Metastases | |||||
| Yes 59 | 54.2 | 1.7 | 22 | 18.6 | 3.4 |
| No 206 | 53.4 | 1.9 | 28.2 | 13.6 | 2.4 |
| PD-L1 TPS (%) | |||||
| <1 100 | 73 | 4 | 1 | 21 | 1 |
| 1-49 70 | 74.3 | 1.4 | 5.7 | 14.3 | 2.9 |
| ≥50 85 | 12.9 | 0 | 76.5 | 7.1 | 3.5 |
| Not evaluable 3 | 66.7 | 0 | 0 | 0 | 33.3 |
Conclusions
The implementation of PD-L1 testing is feasible in the clinical practice and seems to guide treatment decisions with IO, according to the regulation in Spain.
Legal entity responsible for the study
Merck Sharp & Dohme.
Funding
Merck Sharp & Dohme Spain.
Disclosure
B. Rubio-Viqueira: Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Merck Sharp & Dohme; Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Roche; Advisory/Consultancy, Non-remunerated activity/ies: Lilly; Advisory/Consultancy, Speaker Bureau/Expert testimony, Non-remunerated activity/ies: Boehringer Ingelheim. M. Majem Tarruella: Advisory/Consultancy, Travel/Accommodation/Expenses: Merck Sharp & Dohme; Advisory/Consultancy, Research grant/Funding (institution): Bristol Myers Squibb; Advisory/Consultancy, Non-remunerated activity/ies: Boehringer Ingelheim; Advisory/Consultancy, Non-remunerated activity/ies: AstraZeneca; Advisory/Consultancy, Non-remunerated activity/ies: Roche; Advisory/Consultancy: Kyowa Kyrin; Non-remunerated activity/ies: Pierre Fabre; Advisory/Consultancy: Takeda; Non-remunerated activity/ies: Bayer. M.E. Lazaro: Travel/Accommodation/Expenses, Non-remunerated activity/ies: Merck Sharp & Dohme; Advisory/Consultancy, Travel/Accommodation/Expenses, Non-remunerated activity/ies: Roche; Advisory/Consultancy: Boehringer Ingelheim; Advisory/Consultancy, Speaker Bureau/Expert testimony: Bristol Myers Squibb; Advisory/Consultancy, Speaker Bureau/Expert testimony, Non-remunerated activity/ies: AstraZeneca; Advisory/Consultancy: Eusa Pharma; Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Pfizer; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Astellas; Speaker Bureau/Expert testimony: Janssen; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Ipsen; Travel/Accommodation/Expenses: Lilly. S. Vazquez Estevez: Advisory/Consultancy, Non-remunerated activity/ies: Merck Sharp & Dohme; Advisory/Consultancy, Research grant/Funding (institution): Bristol Myers Squibb; Advisory/Consultancy, Non-remunerated activity/ies: Boehringer Ingelheim; Advisory/Consultancy, Non-remunerated activity/ies: AstraZeneca; Advisory/Consultancy, Travel/Accommodation/Expenses, Non-remunerated activity/ies: Roche; Advisory/Consultancy: Kyowa Kyrin; Advisory/Consultancy: Pierre Fabre; Advisory/Consultancy: Takeda; Travel/Accommodation/Expenses: Bayer. J.J. Garcia Gonzalez: Advisory/Consultancy, Non-remunerated activity/ies: Merck Sharp & Dohme; Advisory/Consultancy: Boehringer Ingelheim; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy, Non-remunerated activity/ies: Bristol Myers Squibb; Advisory/Consultancy, Non-remunerated activity/ies: Roche; Advisory/Consultancy, Non-remunerated activity/ies: Lilly; Advisory/Consultancy: Pierre Fabre; Advisory/Consultancy: Novartis; Advisory/Consultancy: Pierre Fabre; Advisory/Consultancy: Sanofi. C. Gonzalez Arenas: Full/Part-time employment: Merck Sharp & Dohme. All other authors have declared no conflicts of interest.