P2.23 Characterization of Hispanic Patients Who Experienced Hyperprogression During Treatment for Advanced NSCLC with Immunotherapy

Abstract

Background: Hispanics in the US have a lower age-adjusted mortality in NSCLC and may have a different gene expression profile than NHWs. Additional data is thus needed to validate outcomes in Hispanic patients with NSCLC treated with ICIs. Our aim was to compare clinical outcomes between Hispanic and NHW patients with advanced NSCLC treated with ICIs at 5 large institutions in the US and Latin America. Method: Retrospective clinical review on 436 Hispanic pts with advanced NSCLC that had failed at least one prior line of chemotherapy or were treated with single-agent immunotherapy as first line. Pts with actionable genetic aberrations (EGFR, ALK, and ROS-1) were excluded. Primary endpoints assessed were OS, PFS, and ORR (CR+PR) while secondary endpoint was DCR (ORR+SD). Results: Patient characteristics are summarized in table 1. Primary endpoint results are summarized in table 2. There were no statistical significant differences seen in the secondary endpoint (DCR) among Hispanics and NHW pts. Conclusion: No significant differences were found in the clinical outcomes between Hispanic and NHW patients despite expected genomic differences. As expected, higher response rates were seen in first line therapy and patients with PD-L1 (+) status. These findings validate efforts in making immunotherapy more available to Hispanic patients worldwide.

Lung Cancer Disparities in Hispanics: Molecular Diagnosis and Use of Immunotherapy

“…Nevertheless, this study also reported a lower overall response rate in Hispanics versus NHWs in patients receiving second-line therapy (18% v 19%), patients with adenocarcinomas (22% v 24%), and patients with PD-L1–positive tumors (29% v 32%); however, none of these differences were statistically significant. Another study, the Quijote study, 26 include 296 Hispanic patients (from México, Costa Rica, Nicaragua, Panama, Colombia, Peru, the United States, and Argentina) with NSCLC treated with immunotherapy in the first-, second-, or third-line or greater setting (13.7%, 48.8%, and 37.6% of patients, respectively). Within this population, the median OS was 19.9 months (95% CI, 14.5 to 22.7 months), and median PFS was 3.73 months (95% CI, 2.8 to 4.2 months).…”

“…Compared with a historical cohort, immunotherapy proved to be superior in terms of OS ( P = .05) but not PFS ( P = .2). The Quijote study 26 also documented 44 patients with hyperprogressive disease (19.8%; 95% CI, 14.5% to 25.1%) who had a median time to progression after immunotherapy of approximately 5 weeks. Factors associated with worst outcomes among Hispanic patients with hyperprogressive disease included albumin and hemoglobin levels, presence of CNS and bone metastasis, and weight loss.…”

Durvalumab After Chemoradiation for Unresectable Stage III Non-Small Cell Lung Cancer: Inferior Outcomes and Lack of Health Equity in Hispanic Patients Treated With PACIFIC Protocol (LA1-CLICaP)

“…Our study reports that overall response to cCRT positively impacts the OS, and the benefit is higher for NHW than for Hispanics (34.9 months vs. 29.2 months, respectively). Previously, some studies documented that complete or partial response to the treatment relates directly to an increased OS ( 25 , 26 ). In this scenario, the outcome is still better for NHW despite the grade of response.…”