Abstract 1324P
Background
Both P and PCT represent standard 1st-line treatment options for aNSCLC with PD-L1 TPS ≥50%. The two strategies have never been compared in a randomized trial.
Methods
256 consecutive patients (pts) with EGFR/ALK/ROS1-wild-type PD-L1 TPS ≥50% aNSCLC receiving P (group A, n-203) or PCT (group B, n-53) as a 1st-line treatment were identified in the electronic databases of 4 Israeli cancer centers. Time-to-treatment failure (TTF) and overall survival (OS) were assessed.
Results
Baseline characteristics were well balanced, except for age and ECOG PS differences in favor of group B (Table). With median follow-up of 9.9 mo [IQR 2.7-18.9] and 6.7 mo [IQR 4.6-10.8] in groups A and B, respectively (p-0.003), 78% and 53% of pts stopped the treatment, and 57% and 30% of pts died in groups A and B, respectively. No statistically significant differences in TTF or OS between the groups were observed (Table). In the univariate analysis, ECOG PS (p-0.0002), age (p-0.01) and smoking history (p-0.003) significantly correlated with TTF; ECOG PS (p<0.0001) and age (p-0.0006) significantly correlated with OS; treatment group, sex, histology, presence of liver or brain metastases did not demonstrate a significant correlation with TTF or OS (p>0.1). In the propensity score matching analysis (n-106; 53 patients in each group matched for age, sex and ECOG PS), no differences in OS or TTF between the groups were observed (Table). Table: 1324P
| Group A (P; n-203) | Group B (PCT; n-53) | p-value | |
| Age, y (range) | 68 (36-97) | 63 (35-87) | 0.02 |
| Men, % | 68 | 58 | 0.2 |
| Smokers, % | 91 | 89 | 0.8 |
| Adenoca/sq cellcarcinoma/other, % | 78/16/6 | 72/19/9 | 0.5 |
| ECOG PS 0+1/2-4/NA, % | 68/31/1 | 85/15/0 | 0.02 |
| Weight loss >5%, % | 26 | 32 | 0.7 |
| Liver metastases, % | 13 | 11 | 1.0 |
| Brain metastases, % | 27 | 26 | 1.0 |
| OS, median (95%CI), mo | 12.5 (9.8-16.4) | 20.4 (10.8-NR) | 0.08 |
| TTF, median (95%CI), mo | 4.9 (3.1-7.6) | 7.9 (4.7-15.6) | 0.09 |
| Propensity score matching analysis (n-106) | |||
| OS, median (95%CI), mo | 13.3 (6.8-20.3) | 20.4 (10.8-NR) | 0.2 |
| TTF, median (95%CI), mo | 7.9 (2.8-12.7) | 7.9 (4.7-15.6) | 0.4 |
Conclusions
P and PCT in the real-world setting are associated with similar outcomes; with the limitations of the retrospective study design and short follow-up, P emerges as a preferable 1st-line treatment option for aNSCLC with PD-L1 TPS ≥50%. Results of subgroup analysis will be presented during the conference.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Israeli Lung Cancer Group.
Funding
Israeli Lung Cancer Group.
Disclosure
E. Dudnik: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self): Boehringer Ingelheim, Roche, AstraZeneca, Pfizer, MSD, BMS, Novartis, Takeda. M. Moskovitz: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Boehringer Ingelheim, Roche, AstraZeneca, MSD, BMS, and Takeda. M. Wollner: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Boehringer Ingelheim, Roche, AstraZeneca, Pfizer, MSD, BMS, Takeda. A. Zer: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Roche, MSD, BMS, AstraZeneca; Research grant/Funding (self): BMS. J. Bar: Research grant/Funding (self): MSD, Roche, Boehringer Ingelheim, AstraZeneca and Pfizer; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: MSD, Roche, Boehringer Ingelheim, AstraZeneca, Pfizer, BMS, Novartis, Takeda, Bayer, Vascular Biogenics, and AbbVie. All other authors have declared no conflicts of interest.