P30.07 Can Response to Chemotherapy Be a Surrogate of Response to Immunotherapy in Second and Subsequent Lines- Real World Data

Abstract

Immunotherapy has evolved as a standard care for first and subsequent lines in advanced non-small cell lung cancer. However, one of the problems in clinical practice is level of overall efficacy rate (20-40%), so population choice to immunotherapy remains difficult. Level of PD-L1, driver mutations, active smoking, aggression pattern, sex, all of them are imperfect. In patients treated with chemotherapy for non-small cell lung cancer, the quality of response to the pemetrexed in first line is a predictor of the benefit from next line. It has also been suggested, that patients with high PD-L1 receptor respond better to chemotherapy. For clinicians, one of the strongest prognostic factors is the period between subsequent lines of therapy. Based on the analysis of our database it can be demonstrated that such a relationship between response on chemotherapy and immunotherapy also exists. 24 patients with NSCLC who received nivolumab between 2016-2019 in second or subsequent lines outside of clinical trials were evaluated. The quality of responses (CR, PR, SD) was assessed, as well as the time between last chemotherapy and nivolumab. Additionally, we evaluated the time from first diagnosis of advanced disease to nivolumab treatment. Nivolumab was administered at the dose of 240 mg every 2 weeks. We evaluated 8 women and 13 men, median age 61. Squamous cell carcinoma was more frequent (16) than adenocarcinoma (8). Two patients had EGFR mutation. Only 6 were active smokers, with 12 other patients being earlier smokers. 2 patients never smoked. PD-L1 expression was unknown.Table 1Interval between both types of therapyTime between CHT and nivolumab (months)/Number of patientsMedian nivolumab injections< 3343-6876-12410>12949 Open table in a new tab Table 2Period from first diagnosis to first administration of nivolumabTime from diagnosis to 1 nivolumab (monts)Number of patientsMedian nivolumab injection<1211512-2459>25838 Open table in a new tab Our results suggest that patients with a long-term response to chemotherapy benefit from nivolumab more than others. This benefit applies not only to the second, but also to subsequent treatment lines.