112 Real-World Outcomes in Patients treated with First-line Anti-PD(L)-1 Immune Checkpoint Inhibitors for Non-Small Cell Lung Cancer - A Single Tertiary Centre Experience

Abstract

Introduction Immune-checkpoint inhibitors (ICI) targeting programmed cell death (ligand) 1 (PD-(L)1) remain a first-line option in patients with advanced non-small cell lung cancer (aNSCLC). However, real-world UK outcomes of ICI-monotherapy remain limited. Methods 101 consecutive patients with aNSCLC receiving first-line ICI-monotherapy were retrospectively reviewed over a five-year period at a tertiary cancer center.. Results 93.1% patients received pembrolizumab as choice of ICI-monotherapy. In total, 71.3% presented with de-novo advanced disease and 71.3% had non-squamous histology, Median age was 70-years (range 43-90), 54.5% male, 75.2% BMI 18.9-29.9, 61.4% with preexisting cardiovascular disease, 90.1% current/ex-smokers, and 82.2% with pre-treatment performance status of 0-1. Ethnicity distribution: 75.2% White, 10.9% Asian (n = 4/11 Bangladeshi), and 5.9% Black. Median IMD rank was 3, with 58.4% between ranks 2-3. PD-L1% was >=90-100 in 27.7% and =65 and SIPS >=1 (neutrophil?>7.5x109/L and/or albumin <35 g/L)was associated with worse OS (HR 3.35, 95%CI 1.80-6.25, p < 0.005; HR 5.33, 95%CI 2.55-11.55, p < 0.005 respectively) and PFS (HR 3.01, 95%CI 1.45-6.23, p < 0.005; HR 6.61, 95%CI 2.29-19.09, p < 0.005 respectively). NLR <5 was associated with better OS and PFS (HR-0.36, 95%CI 0.18-0.72, p < 0.005; HR 0.32, 95%CI 0.13-0.80, p = 0.01 respectively). 41.0% received second-line systemic treatment on progression. Median PFS1 and PFS2 were 276 days (95%CI 203-390) and 156 days (95%CI 99-252) respectively. Of evaluable patients (83.2%), ORR to ICI-monotherapy was 48.8%.. Conclusion Our data demonstrated inferior overall survival with anti-PD(L)1 ICI-monotherapy compared to KEYNOTE-24/42. Further research is required regarding real-world UK outcomes, given a more diverse population compared to trial patients. [Formula presented] Disclosure AS received honorarium from Roche for speaker fees. AJ received grants from Gilead, Roche; received honoraria from AstraZeneca, Johnson& Johnson, MSD, Janssen, Pfizer, Bayer and Roche.