Abstract 1038P
Background
Immune checkpoint inhibitors (ICI) such as programmed death (ligand) 1 [PD(L)-1] inhibitors have dramatically improved patient outcomes in different solid tumors such as lung cancer, melanoma or renal cancer. Data regarding the potential role of metastatic location (ML) as predictive factors of ICI efficacy are limited. We aimed to evaluate the association between ML and PD(L)1 inhibitors efficacy in various malignancies.
Methods
Consecutive patients treated with a single anti-PD(L)-1 agent for different solid tumors from January 2012 to October 2018 were included in a large retrospective multicentric cohort (IMMUCARE). The primary objective was to assess the impact of ML number and ML types (liver vs lung vs brain vs bone) on progression-free survival (PFS) and overall survival (OS). The impact of ML number was assessed using the threshold of 3 ML. OS and PFS were assessed using Kaplan-Meier method. Differences in survival times were compared using standard log-rank tests.
Results
In this cohort of 759 patients, the primary tumor types were non-small cell lung cancer (n = 537, 71%), melanoma (n= 144, 19%) or urologic cancer (n = 78, 10%). Median age was 66 years (19 – 94), 192 patients (26%) had performance status ≥ 2 and 205 patients (27%) had received ≥ 3 lines in metastatic setting. At time of ICI initiation, 261 patients (34%) had at least three ML and 498 patients (66%) had less than three ML, 389 of whom (51%) had only one ML. Patients with at least 3 ML had a shorter median PFS of 2.5 months (95% CI, 1.9-3.2 months) compared with 4.2 months (95% CI, 3.6-5.6 months) of patients with less than 3 ML (P<0,0026). The median OS of patients with at least 3ML was 6.5 months (95% CI, 5.1-8.8 months) compared with 13.2 months (95% CI, 11.6-15.3 months) of patients with less than 3 ML (P<0.0001). These outcomes were confirmed in both lung cancer and melanoma cohorts. ML types (brain, lung, liver or bone) did not impact PFS or OS in the cohort of patients with only one ML.
Conclusions
In this pooled multi-institutional cohort, the presence of more than 3 ML was associated with poorer survival outcomes across different solid tumors treated with anti-PD(L)-1 monotherapy. However ML types did not impact patient outcomes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S. Dalle: Research grant/Funding (institution), Travel/Accommodation/Expenses, Non-remunerated activity/ies: BMS; Research grant/Funding (institution), Travel/Accommodation/Expenses, Non-remunerated activity/ies: MSD; Research grant/Funding (institution): Roche; Non-remunerated activity/ies: Novartis; Non-remunerated activity/ies: Regeneron; Non-remunerated activity/ies: Sanofi. M. Duruisseaux: Honoraria (self), Non-remunerated activity/ies: Roche; Honoraria (self), Non-remunerated activity/ies: BMS; Honoraria (self), Non-remunerated activity/ies: Pfizer; Non-remunerated activity/ies: Nanostring; Honoraria (self): MSD; Honoraria (self): AstraZeneca; Honoraria (self): AbbVie; Honoraria (self), Non-remunerated activity/ies: Takeda; Honoraria (self), Non-remunerated activity/ies: Boehringer Ingelheim; Non-remunerated activity/ies: Blueprint. P-J. Souquet: Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses, Non-remunerated activity/ies: Roche; Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses, Non-remunerated activity/ies: AstraZeneca; Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses, Non-remunerated activity/ies: BMS; Speaker Bureau/Expert testimony, Non-remunerated activity/ies: MSD; Advisory/Consultancy, Non-remunerated activity/ies: Novartis; Leadership role: IFCT. D. Maillet: Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Janssen; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: MSD; Honoraria (self), Advisory/Consultancy: AstraZeneca; Honoraria (self), Advisory/Consultancy: Pfizer; Honoraria (self), Advisory/Consultancy: Ipsen. All other authors have declared no conflicts of interest.