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P. Chalise



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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
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      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  |  Author(s): P. Chalise

      • 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.