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Y. Demura
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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)
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P2.07-013 - Efficacy and Safety of Nivolumab in Non-Small Cell Lung Cancer with Preexisting Interstitial Lung Disease (ID 8210)
09:30 - 09:30 | Author(s): Y. Demura
- Abstract
Background:
Patients with interstitial lung disease (ILD) have a higher incidence of non-small cell lung cancer (NSCLC) and have few treatment options for NSCLC. While immune checkpoint inhibitors (ICI) are used for NSCLC treatment, the incidence of ICI-related ILD in patients with preexisting ILD is still unknown. Therefore, we retrospectively evaluated the efficacy and safety of nivolumab in patients with NSCLC with preexisting ILD.
Method:
We reviewed patients who were administered nivolumab at National Hospital Organization Kyoto Medical Center, Kyoto University Hospital, and Japan Red Cross Fukui Hospital. All patients were initiated on nivolumab therapy between December 24, 2015 and December 31, 2016 and were reviewed until May 31, 2017 or the date of death. We compared the response rate (RR), disease control rate (DCR), overall survival time (OS), incidence of nivolumab-related ILD, and severity of nivolumab-related ILD between patients with and without preexisting ILD.
Result:
Of 173 NSCLC patients administered nivolumab, 14 (8%) had preexisting ILD. The major radiographic pattern of preexisting ILD was a non-specific interstitial pneumonia pattern (10 patients), followed by the usual interstitial pneumonia pattern (4 patients). The RR and DCR were 21% and 57% versus 12% and 40% in patients with and without preexisting ILD (p = .393 and p = .263), respectively. The median OS from the initiation of nivolumab was not reached (95% confidence interval [CI], 4.1 months to not analyzed [NA]) with preexisting ILD and was 11.7 months (95% CI, 7.5 months to NA) without ILD (hazard ratio, 0.71; 95% CI, 0.29 to 1.77). The incidence of nivolumab-related ILD was significantly higher with preexisting ILD than without ILD (50% vs 15%, p = .004); however, the incidence of grade 3 or 4 nivolumab-related ILD was not significantly different in those with and without preexisting ILD (14% versus 6.3%, p = .251). The median time to the onset of nivolumab-related ILD was 2.3 months (range, 0.5 to 4.0 months) with preexisting ILD versus 2.4 months (range, 0.03 to 12.4 months) without ILD. No ILD-related death occurred.
Conclusion:
Treatment with nivolumab in NSCLC patients with preexisting ILD might offer comparable efficacy to that in those without ILD. Although a higher incidence of nivolumab-related ILD was observed in patients with preexisting ILD, incidence of severe nivolumab-related ILD was not significantly different between those with and without preexisting ILD. Additional studies should be conducted to determine the efficacy and safety of nivolumab in patients with NSCLC with preexisting ILD.
