1143P Effect of best response to first-line (1L) treatment (tx) on outcomes with second-line (2L) nintedanib (NIN) + docetaxel (DOC) for patients (pts) with lung adenocarcinoma after 1L immune checkpoint inhibitor (ICI) combination therapy

Abstract

1L ICI combination therapy has transformed the tx paradigm for non-oncogene-addicted NSCLC. Acquired resistance to ICI therapy could be influenced and reversed by the use of subsequent anti-angiogenic therapy. In this setting, non-interventional data may help to guide post-progression therapeutic decision making. We therefore examined tx outcomes with 2L NIN + DOC with respect to response to 1L ICI combination therapy, and performance status (ECOG PS) at baseline. In this analysis of Cohort C of the ongoing, non-interventional VARGADO study (NCT02392455), eligible pts had locally advanced, metastatic or locally recurrent adenocarcinoma NSCLC and received 2L NIN + DOC in routine clinical practice after failure on 1L ICI combined with chemotherapy. The primary endpoint is 1-year survival rate (not yet mature). Tumour response was according to investigator review. In 176 pts enrolled in Cohort C, median age was 63 years (range: 37–84), 106 pts (60.2%) were men, 138 pts (78.4%) had an ECOG PS 0–1, and 157 pts (89.2%) had received prior 1L pembrolizumab-based combination therapy. In the overall population, objective response rate and disease control rate with 2L NIN + DOC were 35.0% (42/120 pts) and 68.3% (82/120 pts), respectively. Median PFS was 4.8 months (95% CI: 3.5–5.3) and no clear differences were seen with respect to best response to 1L therapy. Median OS was 8.1 months (95% CI: 6.3–11.2) in the overall population. There was a possible association between OS benefit with 2L tx and partial response (PR) as best response to 1L therapy (median OS 9.1 months [95% CI: 5.4–18.3]) especially in those pts with ECOG PS 0–1 (median OS 11.2 months [95% CI: 5.2–21.0]). Our results support 2L NIN + DOC as an effective tx option in pts with advanced adenocarcinoma NSCLC following 1L ICI combination therapy. Best response to 1L tx and ECOG PS may be valuable surrogate markers associated with clinical benefit of 2L NIN + DOC. These findings warrant further evaluation of the effect of these parameters on 2L tx outcomes after 1L ICI combination therapy.