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A. Scoppola
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MA 10 - Immunotherapy I (ID 664)
- Event: WCLC 2017
- Type: Mini Oral
- Track: Immunology and Immunotherapy
- Presentations: 1
- Moderators:S. Wang, Robert Pirker
- Coordinates: 10/17/2017, 11:00 - 12:30, Room 303 + 304
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MA 10.06 - Real-World Results in Non-Squamous Non-Small Cell Lung Cancer Patients: Italian Nivolumab Expanded Access Programme (ID 9580)
11:35 - 11:40 | Author(s): A. Scoppola
- Abstract
- Presentation
Background:
Nivolumab monotherapy has shown survival benefit in patients (pts) with different tumors, including melanoma, lung cancer, renal cell carcinoma, head and neck cancer and Hodgkin lymphoma. Controlled clinical trial setting differs from what experienced by pts and physicians in routine clinical practice. Here, we report efficacy and safety results of nivolumab in pts with non-squamous non-small cell lung cancer (Non-Sq-NSCLC) treated in the Expanded Access Programme in Italy.
Method:
Nivolumab was available upon physician request for pts aged ≥18 years who had relapsed after a minimum of one prior systemic treatment for stage IIIB/stage IV non-Squamous NSCLC. Nivolumab 3 mg/kg was administered intravenously every 2 weeks to a maximum of 24 months. Pts included in the analysis had received at least one dose of nivolumab and were monitored for adverse events (AE) using Common Terminology Criteria for Adverse Events.
Result:
Overall, 1588 pts were enrolled in the EAP across 168 Italian centers. Baseline characteristics of pts were representative of Non-Sq-NSCLC population, in the advanced disease setting. As of March 2017, median overall survival (OS) was 11 months (10.0-12.0), with a median follow-up of 7.8 months (1-21.9) and a median of 7 doses (1-46). The best overall response rate (BORR) was 18%, including 10 pts (<1%) with complete response and 280 pts (17.6%) with partial response. Stable disease has been defined for 414 pts (26.0%) and totally 274 (17.2%) patients were treated beyond progression. Response rates and survival were comparable among pts regardless age (< and ≥ 75 years), presence of brain metastasis and number of prior therapies. Overall, among 1588 pts, 1254 discontinued treatment for any reason, with only 93 (7%) pts who discontinued treatment due to adverse events, in line with what observed in previous studies.
Conclusion:
To date, this is the largest clinical experience with nivolumab in a real-world setting and these EAP data are in line with what reported in the registrative phase 3 clinical trial. According to these results, nivolumab seems to be an effective and safe therapy for pre-treated patients with non-squamous NCSLC, supporting its use in current clinical practice.
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P2.01 - Advanced NSCLC (ID 618)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)
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P2.01-075d - Analysis of Early Survival in Patients with Advanced Non-Squamous NSCLC Treated with Nivolumab: The Italian Expanded Access Program Experience (ID 9237)
09:00 - 09:00 | Author(s): A. Scoppola
- Abstract
Background:
In the Checkmate 057 trial, it was observed a slightly higher number of deaths in the nivolumab arm within the first 3 months of treatment. A post-hoc analysis from this study suggested that pts with poorer prognostic factors and/or more aggressive disease combined with low or no PD-L1 expression appeared to be at higher risk of death with nivolumab. Nevertheless, most of pts with these factors were still alive > 3 months in the nivolumab arm and no factors have been identified for selection. Here, we report a similar analysis conducted on pts treated with nivolumab in the Expanded Access Programme (EAP) in Italy.
Method:
Nivolumab was available upon physician request for pts aged ≥18 years who had relapsed after a minimum of one prior systemic treatment for stage IIIB/stage IV non-Squamous NSCLC. Nivolumab 3 mg/kg was administered intravenously every 2 weeks to a maximum of 24 months. Pts included in the analysis had received at least one dose of nivolumab and were monitored for adverse events (AE) using Common Terminology Criteria for Adverse Events.
Result:
In the Italian EAP, of 1559 pts with available survival data, 365 (23.4%) died within the first 3 months. This data is comparable to what observed in the 057 study where (nivolumab arm 20.2% pts died <3 months). Baseline characteristics of the two groups (deaths ≤3 or >3 months) are summarized in the table below. In univariate and multivariate analysis, factors associated with early death were:bone and liver metastases, ECOG PS2 and no prior maintenance therapy. However, majority of pts with these factors did not die within the first 3 months.OS >3 months (1194) OS ≤3 months (n=365) Gender, Male (%) 760 (64) 251 (69) AGE (median; range) ≥70 yrs, n (%) ≥75 yrs, n (%) 66 (27-89) 397 (33) 181 (15) 65 (36-83) 116 (32) 48 (13) SMOKING HABITS, n (%) Former/current smoker Never smoker NA - 865 (79) 232 (21) 97 - 250 (78) 72 (22) 43 ECOG PS, n (%) 0 1 2 NA - 538 (45) 591 (50) 53 (5) 12 - 101 (28) 207 (57) 53 (15) 4 METASTASIS, n (%) Brain Liver Bone Nodes - 296 (25) 208 (17) 429 (36) 877 (73) - 107 (29) 114 (31) 189 (52) 283 (77) EGFR, n (%) 74/1065 (7) 23/312 (7) Maintenance 303 (25) 69 (19)
Conclusion:
These results confirm the pivotal 057 trial suggesting that no single clinical factor can be used for pts selection. PS2, liver or bone metastastatic pts should be followed with attention after starting Nivolumab.
