Author of

• 20171

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  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)

  • 23415

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    P2.07-040 - Pre-Treatment Tumor Volume in Non-Small Cell Lung Cancer (NSCLC) as a Predictor of Response to PD-1 Inhibitors (ID 9632)

    09:30 - 09:30  |  Presenting Author(s): Misako Nagasaka
    • Abstract

    Background:
    PD-1 inhibitors are new anti-cancer treatments that aimed to re-instate the natural anti-cancer immune-mediated cytotoxicity. Although this new class of therapy offers hope for many advanced stage cancer patients (pts), little is known on the characteristics of pts who are likely to respond. We hypothesized that response rate (RR) and overall survival (OS) would be inversely associated with pre-treatment tumor volume (PTV), independent of other variables such as age, lymph node (LN) metastasis and liver metastasis.
    
    Method:
    Data from NSCLC pts who received at least one dose of PD-1 inhibitors before August 31, 2016 were captured from our institution’s pharmacy database. The primary objective was to determine the correlation of PTV to best response, evaluated using RECIST v1.1 criteria. PTV was measured using the Philips Intellispace Multi-Modality Tumor Tracking (MMTT) application. Secondary objectives were estimation of progression free survival (PFS) and overall survival (OS).
    
    Result:
    Data on 113 NSCLC pts with at least one site of measurable disease were captured. They received at least one dose of PD-1 inhibitors prior to data cut-off. Median age was 64 (IQR: 57-70). 64 (56.6%) were male. 69 (61.1%) were treated on a clinical trial. There were 75 (66.4%) adenocarcinoma, 32 (28.3%) squamous cell carcinoma (SCC) and 6 (5.3%) poorly differentiated NSCLC. Median PTV was 60.2 cm[3] (IQR: 15.1-115.8). 89 (78.8%) pts had LN metastasis and 25 (22.1%) had liver metastasis at baseline prior to treatment. 2 (1.8%) had complete response, 25 (22.1%) had partial response, 42 (37.2%) had stable disease and 34 (30.1%) had progression of disease documented as their best response. The association between PTV and best response, considered as an ordered 4-category variable was not strong (Kendall’s tau-b=0.11, p=0.14). PTV, age and LN metastasis were not associated with OS with hazard ratio and p value of hazard ratio (HR) 1.1 [95%CI 0.9-1.46] p=0.26, HR 1 [95%CI 0.96-1.01] p=0.29 and HR 0.8 [95% CI 0.39-1.52] p=0.45, respectively. However, having liver metastasis prior to treatment was associated with significantly shorter survival with HR 2.6 [95%CI 1.35-4.81] p=0.004.
    
    Conclusion:
    Contrary to our hypothesis, pre-treatment tumor volume in NSCLC did not prove to be a predictor of response to PD1 inhibitors but having liver metastasis prior to treatment was associated with significantly shorter survival.