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J. Martínez Pérez



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    P3.02c - Poster Session with Presenters Present (ID 472)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P3.02c-034 - A Single Institution Experience with Immunotherapy as an Effective Therapy Approach of Advance Non-Small Cell Lung Cancer (NSCLC) (ID 3745)

      14:30 - 14:30  |  Author(s): J. Martínez Pérez

      • Abstract

      Background:
      Lung cancer is the leading cause of cancer-related mortality globally. Recent trials results of checkpoint inhibitors have shown that immunotherapy represents a new standard option of care in pretreated patients compared with chemotherapy. Eficacy and toxicity data were assessed in 69 pretreated patients with metastatic NSCLC in our institution.

      Methods:
      A retrospective, non-interventional study was conducted. 69 patients with advanced NSCLC receiving immunotherapy after one or more prior treatment were enrolled between 2013 and 2015. Patients received PD1 and PDL1 checkpoints inhibitors as compassionate use treatment or as clinical trial therapy.

      Results:
      69 patients were analysed with a median age of 64y, including 82.6% males, 54.3% squamous histology and 8.7% never-smoker patients. Mutation profile was defined as negative EGFR/ALK in 95% and positive PDL1 in 30.4%. 68.3% of patients received anti-PD1 therapy vs anti-PDL1 inhibitors (31.7%) as clinical trial therapy (63.8%) vs compassionate use (36.2%). 40 patients (58%) received immnotherapy after two o more previous chemotherapy lines. With a median follow-up of 24.9 months, overall objective response rate was 5.8% with a disease control rate of 58%, with no responses seen at never smokers. Estimated 1year-PFS was 27.5%, with a median of 4.5months. There were no statistically significant differences according to histology (41.4% squamous vs 36.1% nonsquamous, P=0.14) or immunotherapy strategie (47.6% with PDL1 vs 38.6% with PDL1 inhibitors, p=0.55). Positive PDL1 was a prognostic factor for 6-month PFS in nonsquamous histology (64.3 % PDL1+ vs 18.8% PDL1-,p= 0.02, HR:0.24). OS was not reached as 37.7% of patients remain on treatment nowadays. The most common grade 1-2 adverse events were fatigue (55%) and anorexia (26%). 13 patients (17.3%) experienced grade 3 toxicity being pneumonitis the most common cause (5.8%).

      Conclusion:
      Our data are consistent with recent immunotherapy results, showing a clinically meaningful survival benefit vs chemotherapy with similar efficacy and toxicity between PD1 and PDL1 checkpoints inhibitors. PDL1 expression appears to be a prognostic and predictive factor, only for nonsquamous histology.