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Attend this session at the
2019 ASCO Annual Meeting!


Session: Lung Cancer—Non-Small Cell Metastatic

Type: Poster Session

Time: Sunday June 2, 8:00 AM to 11:00 AM

Location: Hall A

A comparative analysis of survival in patients with non-small cell lung cancer with brain metastases receiving intracranial radiation with and without immunotherapy.

Sub-category:
Metastatic Non-Small Cell Lung Cancer

Category:
Lung Cancer—Non-Small Cell Metastatic

Meeting:
2019 ASCO Annual Meeting

Abstract No:
9025

Poster Board Number:
Poster Session (Board #348)

Citation:
J Clin Oncol 37, 2019 (suppl; abstr 9025)

Author(s): Sunita Patruni, Ahmed Khattab, Stephen Abel, Shaakir Hasan, Saleha Rizwan, Gene Grant Finley, Dulabh K. Monga, Vivek Verma, Rodney E Wegner; Allegheny Health Network, Pittsburgh, PA; Department of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA; AHN, Pittsburgh, PA; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Medical Oncology, Allegheny Health Network, Pittsburgh, PA; Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA

Abstract Disclosures

Abstract:

Background: Many patients diagnosed with advanced non-small cell lung cancer (NSCLC) will develop intracranial metastasis, contributing significantly to morbidity and mortality. Immunotherapy (IMT) has emerged as the standard of care in select cases of metastatic NSCLC, though data investigating the survival impact of IMT and radiation (XRT) in these patients is limited. To characterize the survival impact of intracranial XRT and IMT in NSCLC patients with brain metastasis, we analyzed the National Cancer Database (NCDB). Methods: We queried the NCDB for patients with metastatic NSCLC having brain metastasis receiving intracranial XRT ± IMT. Univariable and multivariable analyses identified characteristics predictive of overall survival. Cox proportional hazard ratios with propensity matching mitigated indication bias between the two arms. Results: 13,998 NSCLC patients who received IMT (n = 545) or did not receive IMT (n = 13,545) were eligible for analysis. Univariable analysis demonstrated a median overall survival of 13.1 months (95% CI: 11.8-15.0) vs. 9.7 months (95% CI: 9.5-9.9) (p < 0.0001) and 3-year overall survival of 17% vs. 12% [p < 0.0001; HR: 0.77 (0.71-0.84)] in patients receiving and not receiving IMT respectively. Patients with N3 disease and those diagnosed between 2012 and 2014 were more likely to have received IMT. Receipt of IMT remained an independent predictor of increased survival on propensity score matched multivariable comparison (p = 0.0002). Conclusions: Receipt of IMT was an independent predictor of increased overall survival in patients with NSCLC having intracranial metastasis. Randomized, prospective studies are needed to further validate these findings.

Multivariable Cox Proportional Hazards Models for Overall Survival in NSCLC Patients Receiving Intracranial XRT with and without IMT.

CharacteristicHazard of Death (95% CI)p
Cox Model with Propensity Score
Grade
Well-differentiatedRef
Moderately-differentiated1.10 (0.95-1.27)0.2155
Poorly-differentiated
Extracranial Disease
1.28 (1.21-1.36)< 0.0001
NoRef
Yes1.17 (1.04-1.33)0.0102
Immunotherapy
NoRef
Yes0.82 (0.74-0.91)0.0002

 
Other Abstracts in this Sub-Category:

 

1. Association of STK11/LKB1 genomic alterations with lack of benefit from the addition of pembrolizumab to platinum doublet chemotherapy in non-squamous non-small cell lung cancer.

Meeting: 2019 ASCO Annual Meeting Abstract No: 102 First Author: Ferdinandos Skoulidis
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

2. Real-world outcomes of patients with advanced non-small cell lung cancer (aNSCLC) and autoimmune disease (AD) receiving immune checkpoint inhibitors (ICIs).

Meeting: 2019 ASCO Annual Meeting Abstract No: 110 First Author: Sean Khozin
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

3. RELAY: A multinational, double-blind, randomized Phase 3 study of erlotinib (ERL) in combination with ramucirumab (RAM) or placebo (PL) in previously untreated patients with epidermal growth factor receptor mutation-positive (EGFRm) metastatic non-small cell lung cancer (NSCLC).

Meeting: 2019 ASCO Annual Meeting Abstract No: 9000 First Author: Kazuhiko Nakagawa
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

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