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S. Croci



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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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      P2.07-046 - Nivolumab Exerts Remarkable Antitumor Activity in NSCLC After an Immune-Modulating Biochemotherapy Regimen (ID 10170)

      09:30 - 09:30  |  Author(s): S. Croci

      • Abstract

      Background:
      Dose-dense cisplatin and daily oral etoposide +/- bevacizumab, mAb to the vascular endothelial-growth factor is a safe and active treatment for un-resectable NSCLC patients. It elicited remarkable Immunological effects, including rise in central-memory-T-cells and activated-dendritic cells and decline in regulatory-T-cells, potentially additive to anti-PD-1/PDL-1 immune-checkpoint inhibition. We therefore, performed a retrospective analysis aimed to evaluate both overall survival (OS) and progression free survival (PFS) in patients receiving treatment with Nivolumab, a mAb to PD-1, after they had received different first line chemotherapy regimens.

      Method:
      Statistical analysis (Log-rank test) was performed on forty-nine consecutive NSCLC pts engaged to receive Nivolumab (3mg/kg every 15 days) between October 2015 and December 2016. All of them had received frontline platinum-based doublets for advanced disease and 15 of them had received the mPEBev regimen.

      Result:
      A prolonged PFS was found in patients who received frontline mPEBev compared to the other treatments (mPEBev vs. standard doublets: 14.30 vs. 7.9 months; p=0.038). In this group, we also detected a trend to longer survival (mPEBev vs. standard doublets: 15.6 vs. 11.34 months; p=0.107 with a 12-month-OS-rate of 79% and 32.6%, respectively). We finally recorded that baseline neutrophil and LDH values were correlated with both PFS (neutrophil counts < vs. ≥ median value: 6.28 vs. 14.4 months; P=0.095. LDH < vs. ≥ median value: 14.25 vs. 8.53 months; p= 0.036) and OS (neutrophil counts < vs. ≥ median value: 9.6 vs. 16.8 months; p= 0.101, with a 12-month OS-rate of 42% vs 63%, respectively; LDH < vs. ≥ median value: 16.66 vs. 11.51 months; p=0.039).

      Conclusion:
      Frontline chemotherapy may affect the efficacy of Nivolumab treatment; the mPEBev regimen, in particular, may induces immunological patterns able to improve the effectiveness of PD-1/PDL-1 blockade. Perspective studies and immunological correlations are presently ongoing.