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Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.

Potential interaction of radiation therapy, antibiotic, and steroid use in non-small cell lung cancer patients treated with checkpoint inhibitors: A retrospective analysis.

Sub-category:
Metastatic Non-Small Cell Lung Cancer

Category:
Lung Cancer—Non-Small Cell Metastatic

Meeting:
2019 ASCO Annual Meeting

Abstract No:
e20724

Citation:
J Clin Oncol 37, 2019 (suppl; abstr e20724)

Author(s): Fen Wang, Kevin D'Rummo, Mohammed Al-Jumayli, Lei Pei, Chao Hui Huang; University of Kansas Medical Center, Kansas City, KS; MS 4033, Kansas City, KS; Kansas University Cancer Center, Kansas, KS; University of Kansas Medical Center, Westwood, KS

Abstract Disclosures

Abstract:

Background: The activity of Checkpoint inhibitors (CPI) can be predicted by PD-L1 expression. Recent studies showed that other factors can also have an impact including radiation which is beneficial but the use of antibiotics and steroids can have a deleterious effect. We performed a retrospective analysis of stage IV lung cancer patients treated with CPI at our institution and the impact of radiation treatment as well as the use of antibiotics or steroids in their outcome. Methods: We reviewed the data of 121 patients with stage IV non-small cell lung that were treated with CPI from 2015 to 2017 and analyzed the impact of PD-L1 expression, radiation treatment, steroid and antibiotic use on their progression-free survival (PFS) and overall survival (OS). We determined the use of antibiotics and steroids during any time within 30 days of initiation of treatment with CPI. Results: The median age was 66; there were 57 females and 64 males;23 current smokers, 11 non-smokers and 87 previous smokers; 87 adenocarcinomas, 24 squamous cell histology, and 10 others; 38 patients had low PD-L1 ( < 50%), 46 had high PD-L1 (≥50%) and 37 was unknown. The PFS and OS of patients treated with CPI who had radiation (RT) were not different from patients that did not have RT by Gehan-Breslow Wilcoxon test nor there was a difference based on the PD-L1 expression. The use of steroids (S) had a beneficial impact on PFS but it was numerically better but not significant on OS. Antibiotic (AB) use also had a beneficial impact on PFS and OS. Patients that had CPI as first-line therapy had shorter PFS than patients that had CPI as second-line therapy. There was no difference whether RT was used or not in patients that had antibiotics or steroids. Conclusions: Our analysis showed that several factors can potentially impact the PFS and OS of patients treated with CPI. Contrary to the previous report, the use of Ab or S did not affect adversely the PFS and OS. We did not observe a beneficial effect of RT. The sequence of use of CPI could potentially affect the PFS. This data should be taken with caution as it is a retrospective analysis with a small sample number but it reflects the real-life practice of patients treated outside of a clinical trial setting.

PFS in daysPOS in daysP
RT +3270.404940.94
RT -285510
AB +3820.027220.03
AB -279397
S+3820.026800.06
S-239381
CPI 1st2200.034600.25
CPI 2nd345522

 
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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