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R. Descourt
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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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P2.07-030 - Real Life Second-Line Nivolumab in Advanced Non-Small-Cell-Lung Cancer: A French Observational Multicenter Study of 259 Patients (ID 9092)
09:30 - 09:30 | Author(s): R. Descourt
- Abstract
Background:
Survival data with nivolumab are based on selected populations and might not reflect outcomes in clinical practice. Overall Survival (OS) and Progression Free Survival (PFS) with anti-PD1 therapy in a large population of unselected patients with advanced Non-Small-Cell-Lung Cancer (NSCLC) are not well documented. We aimed to assess survival data with nivolumab in a large cohort of unselected patients and association of OS with clinical and biological factors.
Method:
Clinical and survival data were collected in a cohort of NSCLC patients treated with nivolumab who experienced confirmed progressive disease (PD) after ≥ 1 line of chemotherapy (CT). Patients received nivolumab at a dose of 3 mg/kg every 2 weeks until PD or unacceptable toxicity. Nivolumab benefit was analyzed according to PFS and OS. The overall response rate (ORR) was analyzed by RECIST 1.1. Age, response to prior CT, eosinophil counts (Ec), prior radiotherapy (RT), lymphocyte counts (Lc), neutrophil counts (Nc), LDH rate were assessed. Kaplan-Meier and Cox regression were performed.
Result:
257 patients treated with nivolumab were enrolled from 9 centers between Sept. 2015 and Oct. 2016. Median age was 62 years [29-85]; 186 patients were males (72%), 93% PS≤1 at the time of the diagnostic; 220 (86%) smokers; 219 (85%) stage IV ; 130 patients (51%) received prior RT. 163 patients (63%) had adenocarcinoma, 70 (27%) squamous cells carcinoma ; 54 (21%) were KRASmut, 11 (4%) EGFRmut, 3 (1%) ALKpositive. PD-L1 expression was unknown (test not required in current practice for nivolumab). The median of prior lines was 1 [1-6]. Median PFS with nivolumab was 3 months [1,9-4]. Median OS was 15 months [1-; NR]. The ORR was 23% (58 patients), the disease control rate was 42% (109 patients). The median duration of response was 6 months [1- ;16]. Age (> or < 70) (p=0.202), response to prior CT (p=0.05) and Ec ≥ 0.5 G/l (p=0.606) were not significantly associated with improved OS. Prior RT was significantly associated with poor OS (p=0.004). Lc < 1 G/l (p=0.019), Nc ≥ 7 G/l (p=0.018), LDH ≥ 500 U/l (p=0.008), were significantly associated with poor OS.
Conclusion:
1) Efficacy of nivolumab in real life is the same as reported in published studies with a median OS of 15 months in clinical practice. 2) In our study neutrophil, lymphocyte and LDH rates predict a poor OS.
