O.02 Long-term Survival Outcomes with Nivolumab (NIVO) in Pts with Previously Treated Advanced Non-Small Cell Lung Cancer (NSCLC): Impact of Early Disease Control and Response

Brahmer, Julie R.; Horn, Leora; Hossein, Baharvand; Ramalingam, Suresh S.; Płużański, Adam; Burgio, Marco Angelo; Garassino, Marina Chiara; Chow, Laura Q.M.; Gettinger, Scott; Crinò, Lucio; Planchard, David; Butts, Charles; Drilon, Alexander; Wójcik-Tomaszewska, Joanna; Otterson, G.; Agrawal, Shruti; Li, A.; Penrod, John R.; Antonia, Scott; Bautista, Y.

doi:10.1016/j.jtho.2019.09.089

Cited by 9 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, 16% of the patients in our study were heavily pretreated, receiving nivolumab as a later than 2 nd treatment line. It should be noted that despite these poor prognostic characteristics, the long-term survival curve looks similar, with 16% long term survivors at data cut-off, consistent with data from the previously mentioned checkmate trials (2)(3)(4).…”

Section: Discussionsupporting

confidence: 84%

“…Based on long-term (four years) follow up of our cohort, we report now real-world data of survival of a set of NSCLC patients treated with 2 nd -line or higher ICI. In our study, the median OS of nivolumab-treated patients compares unfavorably with the (2)(3)(4), as may be expected when comparing real-world data to clinical trial data. DC6 was found to be a strong predictor of OS in our cohort, consistent with published data analysis from these two checkmate trials (3).…”

Section: Discussionsupporting

confidence: 55%

“…Lung cancer is the leading cause of cancer -related death worldwide (1). Immune checkpoint inhibitors (ICI) for treatment of NSCLCdemonstrated superior survival of patients treated with the anti-PD-1 antibody nivolumab compared with docetaxel after failure of platinum-based chemotherapy (2)(3)(4). Pembrolizumab, another PD-1 inhibitor, and atezolizumab, an anti-PD-L1 inhibitor, have both also demonstrated significantly better overall survival (OS) in similarly designed trials, comparing each of them with 2 nd -line docetaxel (5,6).…”

Section: Introductionmentioning

confidence: 99%

“…Response rate (RR) for each of these drugs in the 2 nd line setting is roughly 15-20%. Combined updated OS results from checkmate 017 and checkmate 057 show 13.4% OS rate at five years follow-up ( 3 ). In a landmark analysis of OS by response category at six months in checkmate 017 and checkmate 057, the OS rate at four years in nivolumab treated patients with CR/PR was 58%, and 19% for patients with SD at six months ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Nivolumab in Non-Small Cell Lung Cancer: Real World Long-Term Survival Results and Blood-Based Efficacy Biomarkers

et al. 2021

View full text Add to dashboard Cite

ObjectivesWe aimed to examine clinical data and baseline blood test results as potential predictive biomarkers for benefit from nivolumab, in advanced non-small cell lung cancer patients (NSCLC).Materials and MethodsA chart review was performed of 108 advanced NSCLC patients who commenced treatment with nivolumab between 2015-6 at three Israeli cancer centers, and for whom laboratory tests results were available. Data collected included sex, age, ECOG-PS, histology and number of previous lines of treatment. Baseline blood test results collected: absolute lymphocyte and neutrophil count (ANC), white blood cells (WBC), hemoglobin, platelets, albumin and lactate dehydrogenase (LDH). Neutrophil to Lymphocyte Ratio and ‘derived NLR’ (dNLR = (ANC/[WBC-ANC])) were calculated. Disease control at six months (DC6) was defined as any tumor shrinkage or stable disease during the first six months of nivolumab treatment. The association between clinical/laboratory variables and survival was tested with a Cox proportional hazard model. Data cut-off occurred in November 2019.Results35 patients (32.4%) achieved DC6. Median overall survival (OS) of entire study population was 5.4 months. Four year survival rate was 16%. Achievement of DC6 strongly correlated with longer OS (HR 0.12, 95% C.I. 0.07-0.21, p<0.001). In univariate and multivariate analysis, dNLR, albumin and LDH correlated significantly with OS. No variables correlated significantly with DC6 in multivariate analysis. Based on albumin and LDH, we produced a score called CLAS (combined LDH and albumin score), including four prognostic groups of patients. Patients having low albumin and high LDH had the worst prognosis.ConclusionIn real-life setting, long-term efficacy of nivolumab in advanced line treatment of NSCLC is consistent with clinical trials. Response or stability of disease during first six months of treatment is associated with prolonged survival. We propose a novel score (CLAS) that may be useful for predicting outcome in nivolumab-treated NSCLC patients, but further validation is required.

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Nivolumab in Non-Small Cell Lung Cancer: Real World Long-Term Survival Results and Blood-Based Efficacy Biomarkers

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In addition, the definition of HPD does not include patients who experience an early death and does not represent the entire population of patients who never benefit from immunotherapy. A combined analysis of the CheckMate017 and CheckMate057 studies revealed that nivolumab treatment was associated with four‐year OS rates of 58% for CR/PR cases, 19% for SD cases, and 4% for PD cases, relative to a four‐year OS rate of 5% for docetaxel treatment . This suggests that the OS after starting immunotherapy is closely related to the RECIST v1.1‐based response, and immunotherapy is associated with a lower four‐year OS rate than docetaxel in patients with PD.…”

Section: Discussionmentioning

confidence: 99%

Factors related to rapid progression of non‐small cell lung cancer in Chinese patients treated using single‐agent immune checkpoint inhibitor treatment

et al. 2020

View full text Add to dashboard Cite

Background: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of non-small cell lung cancer (NSCLC). While rapid progression (RP) has been proposed as a non-negligible pattern of response to ICIs, its definition and related factors remain unclear. This study aimed to develop a clinical definition of RP and to identify related factors. Methods: We retrospectively evaluated Chinese patients who had received an ICI as second-line or later treatment for locally advanced or metastatic NSCLC at a single center. We defined RP as radiological progression at the first response assessment (<2 months after starting the ICI), as well as confirmation of progressive disease or cancer-related death occurring at <3 months. The clinical outcomes were compared for patients with RP or non-RP to identify prognostic factors. Results: The study evaluated 74 eligible patients with detailed records regarding their ICI therapy, including 25 patients (33.8%) who had experienced RP. Relative to patients with non-RP, patients with RP had significantly shorter median progression-free survival (1.7 months [95% CI: 1.4-2.0 months] vs. 6.3 months [95% CI 5.2-7.3 months], P < 0.001; hazard ratio: 0.14, 95% CI: 0.08-0.25) and significantly shorter median overall survival (8.2 months [95% CI 3.0-13.4 months] vs. 22.6 months [95% CI 17.0-28.1 months], P < 0.001; hazard ratio: 0.27, 95% CI: 0.15-0.49). Multivariate analysis revealed that RP was independently predicted by the presence of ≥3 metastatic sites (P = 0.039) and a neutrophil-to-lymphocyte ratio of ≥3 (P = 0.044). Conclusions: Among NSCLC patients, RP was a common response to ICI monotherapy and was associated with dramatically reduced progression-free and overall survival. Care is needed when selecting ICI monotherapy for these patients, especially if they have ≥3 metastatic sites or a neutrophil-to-lymphocyte ratio of ≥3. Key pointsSignificant findings of the study: Patients with rapid progression after immune checkpoint inhibitor monotherapy had poor survival outcomes. The number of metastatic sites and the neutrophil-to-lymphocyte ratio may independently predict treatment response in this setting.What this study adds: This is the first study to evaluate rapid progression after second-line or later single-agent immunotherapy in a Chinese population. Our findings may help establish effective immunotherapy strategies for NSCLC.

show abstract

Immune Therapy: What Can We Learn From Acquired Resistance?

2021

View full text Add to dashboard Cite

O.02 Long-term Survival Outcomes with Nivolumab (NIVO) in Pts with Previously Treated Advanced Non-Small Cell Lung Cancer (NSCLC): Impact of Early Disease Control and Response

Cited by 9 publications

References 0 publications

Nivolumab in Non-Small Cell Lung Cancer: Real World Long-Term Survival Results and Blood-Based Efficacy Biomarkers

Nivolumab in Non-Small Cell Lung Cancer: Real World Long-Term Survival Results and Blood-Based Efficacy Biomarkers

Factors related to rapid progression of non‐small cell lung cancer in Chinese patients treated using single‐agent immune checkpoint inhibitor treatment

Immune Therapy: What Can We Learn From Acquired Resistance?

Contact Info

Product

Resources

About