Author of

• 20171

  +

  P2.07 - Immunology and Immunotherapy (ID 708)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Immunology and Immunotherapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23394

    +

    P2.07-019 - Role of Anti-Angiogenesis on the Prognosis in Advanced Non-Small Cell Lung Cancer Who Are Treated with Immunotherapy (ID 8503)

    09:30 - 09:30  |  Presenting Author(s): Takefumi Komiya
    • Abstract

    Background:
    Recent development of cancer immunotherapy such as anti-PD-1 inhibitors improved outcome and changed therapeutic landscape in advanced non-small cell lung cancer (NSCLC). However, systemic treatment prior to immunotherapy might influence host T-cell function and therapeutic outcome. Previous anti-angiogenesis treatment may positively or negatively affect outcome of subsequent immunotherapy.
    
    Method:
    We conducted a retrospective review of advanced NSCLC patients who were treated with anti-PD-1/PD-L1 inhibitor at University of Kansas Medical Center. Patient characteristics including prior systemic therapy were investigated for association with therapeutic outcome, which included disease control rate (DCR: CR+PR+SD/CR+PR+SD+PD), progression-free survival (PFS), overall survival (OS), and reason for discontinuation of immunotherapy. Kaplan–Meier curves were fitted and the differences were assessed using Log-rank test. In addition, Cox proportional hazard model was used in order to assess the effects of variables on survival of the patients. Association between anti-angiogenesis treatment and other clinical features was assessed using chi-squared or Fisher’s exact test.
    
    Result:
    Among 141 patients who were treated with anti-PD-1/PD-L1 inhibitor, we analyzed only those who were treated with nivolumab (n=134). Majority of patients had age<70 (76%), stage IV at diagnosis (66%), nonsquamous histology (58%), male sex (58%), performance status 0-1 (77%), EGFR negative or unknown (94%), one prior systemic treatment regimen (81%), and no prior anti-angiogenesis agent (88%). There was significant correlation between prior anti-angiogenesis and stage IV at diagnosis/nonsquamous histology/higher number of systemic treatment lines. With a median follow up of 22.8 weeks, prior use of anti-angiogenesis agent was significantly associated with shorter PFS (Table). There was also a trend of inferior DCR and OS (Table). Multivariate analysis demonstrated that prior anti-angiogenesis agent use had shorter PFS (p=0.0444) and OS (p=0.0741). Frequency of adverse event for reason of discontinuation was not statistically significant.

    Table: Influence of prior anti-angiogenesis treatment

    Prior anti-angiogenesis	N	DCR%	median PFS (weeks)	median OS (weeks)
    Yes	16	30.0	8.29	13.1
    No	118	60.7	11.3	27.5
    P-value		0.0912	0.0060	0.1697
    Statistical method		Fisher’s exact	Log-rank	Log-rank

    
    
    Conclusion:
    This retrospective analysis suggests prior exposure to anti-angiogenesis agent negatively impact on therapeutic outcome of cancer immunotherapy.