1374P - Docetaxel/nindetanib as efficient treatment option after failure of immune checkpoint inhibition: Real-world evidence

Background

The widespread use of immune checkpoint inhibitors for treatment of non-small cell lung cancer patients (pts) particularly as 1^st- or 2^nd-line treatment inevitably begs the question about effective subsequent treatment options. The combination of docetaxel/nintedanib might be an especially effective option. Here, we provide clinical data from pts subsequently treated with docetaxel/nintedanib after checkpoint inhibition as 2^nd, 3^rd, and 4^th line therapies.

Methods

Data from seven German hospital sites and oncologists were retrospectively collected and analyzed. Treatments and response evaluations were performed according to the centers’ routine standards.

Results

93 pts were treated with docetaxel/nintedanib after pre-treatment with checkpoint inhibitors. The majority received docetaxel/nintedanib as 3^rd-line after 1^st-line chemotherapy and 2^nd-line checkpoint inhibition (n=57). Other regimens included 2^nd-line docetaxel/nintedanib after combination of chemotherapy with checkpoint inhibitors (n=9), 3^rd-line docetaxel/nintedanib after 1^st-line pembrolizumab and 2^nd-line chemotherapy (n=7) and docetaxel/nintedanib in >= 4^th-line (n=20). Response rates (RRs) were assessed for 76 pts. While RR were not available for 11 pts, 6 pts (6.4%) had to interrupt therapy due to diarrhea of >= grade 3 before RR assessment, but no new additional toxicity was noted. Overall RR was 49% (n=37), while 28% (n=21) had stable disease and 23% (n=18) had disease progression. The highest RR was observed when pts received docetaxel/nintedanib as 3^rd-line treatment (n=57, ORR=57%). Notably, of the 6 evaluable pts with docetaxel/nintedanib after 1^st-line combination therapy, 3 pts had partial response and 3 pts had disease progression. Median time on therapy was 4 months for pts receiving nintedanib as a 3^rd line treatment directly after checkpoint inhibition (n=57) and overall survival was 8.6 months in these pts. Nintedanib maintenance therapy occurred in 23 of 93 pts (25%) for a median time of 4.3 months.

Conclusions

We provide the so far largest data set of pts treated with docetaxel/nintedanib after failure of checkpoint inhibition. Our data support the use of an anti-angiogenic strategy in this setting.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

PD Dr. med. D. C. Christoph.

Funding

Has not received any funding.

Disclosure

D.C.C. Christoph: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Bayer; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses, Non-remunerated activity/ies: Boehringer Ingelheim; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Bristol-Myers Squibb; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Chugai; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Merck, Sharp & Dohme; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Novartis; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Pfizer; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Roche; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Takeda. F. Rizzo: Travel/Accommodation/Expenses, Non-remunerated activity/ies: Boehringer Ingelheim. K-O. Kambartel: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses, Non-remunerated activity/ies: Boehringer Ingelheim. S. Winke: Non-remunerated activity/ies: Boehringer Ingelheim. J. Panse, D.S. Abdulla M. Scheffler, I.T. Azeh, M. Hoiczyk: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses, Non-remunerated activity/ies: Boehringer Ingelheim. A. Turki: Non-remunerated activity/ies: Boehringer Ingelheim; Advisory/Consultancy: CSL Behring; Advisory/Consultancy: Jazz; Advisory/Consultancy: Merck, Sharp & Dohme; Travel/Accommodation/Expenses: Neovii. M. Metzenmacher: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses, Non-remunerated activity/ies: Boehringer Ingelheim; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Bristol-Myers Squibb; Travel/Accommodation/Expenses: Lilly; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Merck, Sharp & Dohme; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Roche; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Takeda.