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
The efficacy of immune checkpoint inhibitors and PD-L1 status in patients with advanced non-small cell lung cancer harboring oncogenic driver alterations: Immuno-oncology biomarker study in LC-SCRUM-Japan.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2019 ASCO Annual Meeting
Poster Board Number:
Poster Session (Board #369)
J Clin Oncol 37, 2019 (suppl; abstr 9046)
Author(s): Kiyotaka Yoh, Shingo Matsumoto, Kei Kunimasa, Masahiro Kodani, Koichi Nishi, Taku Nakagawa, Shunichi Sugawara, Tomohiro Kato, Jun Sakakibara-Konishi, Yuichiro Hayashi, Koji Tsuta, Noriko Motoi, Genichiro Ishii, Koichi Goto; National Cancer Center Hospital East, Kashiwa, Japan; Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan; Faculty of Medicine, Tottori University, Tottori, Japan; Ishikawa Prefecutual Central Hospital, Kanazawa, Japan; Department of Thoracic Surgery, Omagari Kosei Medical Center, Akita, Japan; Sendai Kousei Hospital, Sendai, Japan; National Hospital Organization Himeji Medical Center, Himeji, Japan; Hokkaido University Hospital, Sapporo, Japan; Keio University School of Medicine, Tokyo, Japan; Kansai Medical University, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan
Background: The efficacy of immune checkpoint inhibitors (ICI) and PD-L1 status in patients with advanced non-small cell lung cancer (NSCLC) harboring oncogenic alterations has not been fully investigated. We initiated this immuno-oncology biomarker study as part of nationwide genomic screening by LC-SCRUM-Japan (LC-SCRUM-IBIS). Methods: Lung cancer patients enrolled in LC-SCRUM-IBIS underwent targeted next-generation sequencing (NGS) with Oncomine Comprehensive Assay, PD-L1 immunohistochemistry (IHC) assays and further whole-exome sequencing (WES) to determine tumor mutation burden. According to subtype of oncogenic alterations, the efficacy of ICI and PD-L1 status were analyzed. Results: Between Feb 2017 and May 2018, 1017 lung cancer patients were enrolled. Of these, 832 NSCLC patients had adequate tumor samples and were included in this analysis. Targeted NGS showed that major oncogenic alterations included 157 EGFR, 83 KRAS, 33 MET, 30 HER2, 25 FGFR, 22 PIK3CA, 19 ALK, 15 ROS1, 10 RET, 5 BRAF and 13 others. High expression of PD-L1 ( > 50% of tumor cells by 22C3) were observed in RET (70%), MET (67%), ROS1 (53%), KRAS (41%) and BRAF (40%) positive tumors. One-hundred five patients were evaluable for the efficacy of ICI, including 80 non-squamous and 25 squamous histology. Among them, 104 were treated with PD-1/PD-L1 monotherapy and only 1 in combination therapy of ICI. Median treatment line was 2 (range, 1-9). The response rate was 19% (20/105) and median progression-free survival (PFS) and overall survival (OS) were 3.3 and 18.3 months. In 50 patients harboring at least one oncogenic alterations, the response rate, PFS and OS were 18% (9/50), 3.3 and 24.8 months. Among 9 responders to ICI, 3 had KRAS, 2 had MET and 1 each had ALK/EGFR/HER2/RET. Six (26%) of 23 patients with both high PD-L1 expression and at least one oncogenic alterations responded to ICI. Conclusions: PD-L1 status seemed to vary among patients with advanced NSCLC harboring oncogenic alterations. New biomarker for ICI therapy in this population should be moreover explored. Updated results on WES analysis will be presented at the meeting.