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e-Poster Display Session

42P - Pleural effusion is a negative prognostic factor for immunotherapy in non small cell lung cancer (NSCLC): The PLUIE study

Date

09 Dec 2020

Session

e-Poster Display Session

Topics

Tumour Site

Non-Small Cell Lung Cancer

Presenters

Nicolas Epaillard

Citation

Annals of Oncology (2020) 31 (suppl_7): S1428-S1440. 10.1016/annonc/annonc391

Authors

N. Epaillard1, J.C. Benitez2, T. Gorria3, E. Fabre-Guillevin4, M. Ruidavets5

Author affiliations

  • 1 Oncology, Hopital Européen Georges Pompidou, 94800 - Paris/FR
  • 2 Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif/FR
  • 3 Hospital Clinic, Barcelona/ES
  • 4 Hopital Européen Georges Pompidou, Paris/FR
  • 5 Hospital Clinic y Provincial de Barcelona, Barcelona/ES
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Abstract 42P

Background

Pleura is a common site of metastatic involvement in patients (pts) with NSCLC. Pleura is a natural barrier that can limit the penetration and efficacy of immune checkpoint inhibitors (ICI). We aimed to assess the clinical outcome of pleural effusion (PE) in pts with NSCLC and treated with ICI.

Methods

Multicentre international retrospective study of pts with NSCLC treated with ICI between November 2012 and 2019. We stratified the population according to PE vs. Non-PE at IO baseline. Primary endpoints were overall survival (OS) and early death rate (EDR). Secondary outcomes were progression free survival (PFS) and disease control rate (DCR). Association between outcomes and PE was evaluated with logistic regression. Univariate and multivariate Cox models were performed for OS and PFS.

Results

538 pts were included: 196 in the PE group and 342 in the non-PE group. In the overall population, median age was 63 years,35% were female, 9% were never smokers and 85% had a non-squamous NSCLC. In the PE group, median age was 65 years, 32% were female, 12% were never smokers and 78% presented a non-squamous NSCLC. ICI was administered in 1st or 2nd line in 66% of pts, in monotherapy in 94%. PE was associated with higher number of metastatic sites (median 3 vs. 2), and worse performance status (PS≥2, 91% vs 81% in non-PE). Overall, the median OS was 9.7 months (mo) (95%CI: 8.0-11.8); 6.3 mo (4.0-8.6) in PE vs. 11.4 mo (9.7-13.8) in the non-PE respectively, p=0.002. Overall, the ED rate was 31.4%; higher in the PE group (38% vs. 27.5%; OR 1.63, 95%CI: 1.13-2.37, p=0.01). The PFS in the PE group was1.8mo (1.7-2.5) vs. 2.3mo (2.0-3.6), p=0.08. After adjustment on PS, liver/intracanial/bone metastasis, immunotherapy line and dNLR, PE remained an independent prognostic factor for OS (HR: 1.38, 95%CI: 1.09-1.74, p=0.007) and PFS (HR: 1.35, 95%CI: 1.09-1.68, p=0.006). DCR was 40% in the PE vs. 52% in non-PE (OR 1.64, 95%CI: 1.14-2.40, p=0.01). Among the PE cohort (n=196), pleural evacuation (n=73 pts, 37%) patients required pleural evacuation was performed (37%); this requirement was associated with more ED (52% vs 31%, p=0.003).

Conclusions

PE is associated with worse prognosis and lower responses to ICI.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

D. Planchard: Honoraria (self), Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self): Bristol Myers Squibb; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self): Boehringer Ingelheim; Honoraria (self), Advisory/Consultancy: Celgene; Advisory/Consultancy, Research grant/Funding (self): Daiichi Sankyo; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self): Eli Lilly; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self): Merck; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: Novartis; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: Pfizer; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: prIME Oncology; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Peer CME; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self), Travel/Accommodation/Expenses: Roche; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self): Samsung; Research grant/Funding (self): MedImmune; Research grant/Funding (self): Sanofi Aventis; Research grant/Funding (self): Taiho Pharma. N. Reguart Aransay: Honoraria (self), Research grant/Funding (self): Pfizer; Honoraria (self), Research grant/Funding (self): Novartis; Honoraria (self), Advisory/Consultancy: BMS; Advisory/Consultancy: Amgen; Honoraria (self), Advisory/Consultancy: Boehringer Ingelheim; Honoraria (self), Advisory/Consultancy: MSD; Honoraria (self), Advisory/Consultancy: Guardant; Honoraria (self), Advisory/Consultancy: AstraZeneca; Honoraria (self), Advisory/Consultancy: Roche; Honoraria (self), Advisory/Consultancy: Lilly; Advisory/Consultancy: TakedA. B. Besse: Research grant/Funding (institution): Abbvie; Research grant/Funding (institution): Amgen; Research grant/Funding (institution): AstraZeneca; Research grant/Funding (institution): BeiGene; Research grant/Funding (institution): Blueprint Medecine; Research grant/Funding (institution): BMS; Research grant/Funding (institution): Boehringer Ingelheim; Research grant/Funding (institution): Celgene; Research grant/Funding (institution): Cristal Therapeutics; Research grant/Funding (institution): Daiichi-Sankyo; Research grant/Funding (institution): Eli Lilly; Research grant/Funding (institution): GSK; Research grant/Funding (institution): Inivata; Research grant/Funding (institution): Ipsen; Research grant/Funding (institution): Ignyta; Research grant/Funding (institution): Janssen; Research grant/Funding (institution): Merck KGaA; Research grant/Funding (institution): MSD; Research grant/Funding (institution): Nektar; Research grant/Funding (institution): Onxeo. L. Mezquita: Advisory/Consultancy, Research grant/Funding (self): Bristol Myers Squibb; Research grant/Funding (self): Boehringer Ingelheim; Research grant/Funding (self): Amgen; Advisory/Consultancy, Travel/Accommodation/Expenses: Roche; Advisory/Consultancy: Takeda; Non-remunerated activity/ies, Mentorship program: AstraZeneca. E. Auclin: Honoraria (self): Sanofi-Genzymes; Travel/Accommodation/Expenses: Mundipharma. All other authors have declared no conflicts of interest.

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