TY - JOUR
T1 - Response rates to single-agent chemotherapy after exposure to immune checkpoint inhibitors in advanced non-small cell lung cancer
AU - Schvartsman, Gustavo
AU - Peng, S. Andrew
AU - Bis, Giorgios
AU - Lee, J. Jack
AU - Benveniste, Marcelo F.K.
AU - Zhang, Jianjun
AU - Roarty, Emily B.
AU - Lacerda, Lara
AU - Swisher, Stephen
AU - Heymach, John V.
AU - Fossella, Frank V.
AU - William, William N.
N1 - Funding Information:
This study was supported by the generous philanthropic contributions to The University of Texas MD Anderson Lung Moon Shot Program, the Mayberry Foundation , and the NCI (award number P30CA016672).
Funding Information:
This study was supported by the generous philanthropic contributions to The University of Texas MD Anderson Lung Moon Shot Program, the Mayberry Foundation, and the NCI (award number P30CA016672).
Funding Information:
GS, AP, GB, JL, MB, JZ, ER, LL, SS and FF have no disclosures. JH has a consulting or advisory role for AstraZaneca, Abbvie, Boehringer Ingelheim, Bristol-Myers Squibb, Medivation, ARIAD, Synta, Oncomed, Novartis, Genentech and Calithera Biosciences. JH has stock and other ownership interests from Cardinal Spine and Bio-Tree. JH has received research funding from AstraZaneca through his institution. WW has a consulting or advisory role for Clovis Oncology and AstraZaneca. WW is on the speaker’s bureau for Boehringer Ingelheim. WW has received honoraria from Roche/Genentech, AstraZaneca, Boehringer Ingelheim, Bristo-Myers Squibb and Merck. WW receives research funding from OSI Pharmaceuticals, Boehringer Ingelheim, Bristo-Myers Squibb, Lilly and Merck through his institution.
Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/10
Y1 - 2017/10
N2 - Introduction Exploratory analysis of clinical trials in various tumor types have demonstrated potential improvements in overall response rate (ORR) to chemotherapy after exposure to vaccine-based immunotherapy. The objective of this retrospective study was to determine if single-agent chemotherapy (3rd-line or beyond) would yield improved ORR when given after exposure to programmed death-(ligand)1 inhibitors (anti-PD1) in metastatic non-small cell lung cancer (NSCLC). Materials and methods We queried the Thoracic GEMINI database of MD Anderson Cancer Center for patients treated between 06/12 and 11/16 who received at least one single-agent chemotherapy as 3rd-line or beyond, following progression after platinum-based chemotherapy and anti-PD1. We evaluated efficacy outcomes to each therapy, including ORR by RECIST version 1.1, progression-free survival (PFS), and overall survival (OS). Results Out of 306 anti-PD1-treated patients registered in the database, 28 met eligibility criteria − 54% were male, median age was 66 years, 82% had adenocarcinoma, and 71% were former/current smokers. The anti-PD1 and single-agent chemotherapy most commonly used were nivolumab (86%) and docetaxel (50%), respectively. ORR to single-agent chemotherapy after exposure to anti-PD1 was 39% (11/28 patients, 8 confirmed). In contrast, ORR to first-line chemotherapy in this cohort was 37%. Liver metastasis was the only factor associated with response to single-agent chemotherapy on univariate analysis (p < 0.05). Conclusion In NSCLC patients, the confirmed ORR to single-agent chemotherapy after immunotherapy exposure was higher as compared to historical data from the pre-anti-PD1 era, and approached ORR to first-line platinum-based chemotherapy. Further investigation of a possible immunotherapy-induced chemosensitization effect is warranted.
AB - Introduction Exploratory analysis of clinical trials in various tumor types have demonstrated potential improvements in overall response rate (ORR) to chemotherapy after exposure to vaccine-based immunotherapy. The objective of this retrospective study was to determine if single-agent chemotherapy (3rd-line or beyond) would yield improved ORR when given after exposure to programmed death-(ligand)1 inhibitors (anti-PD1) in metastatic non-small cell lung cancer (NSCLC). Materials and methods We queried the Thoracic GEMINI database of MD Anderson Cancer Center for patients treated between 06/12 and 11/16 who received at least one single-agent chemotherapy as 3rd-line or beyond, following progression after platinum-based chemotherapy and anti-PD1. We evaluated efficacy outcomes to each therapy, including ORR by RECIST version 1.1, progression-free survival (PFS), and overall survival (OS). Results Out of 306 anti-PD1-treated patients registered in the database, 28 met eligibility criteria − 54% were male, median age was 66 years, 82% had adenocarcinoma, and 71% were former/current smokers. The anti-PD1 and single-agent chemotherapy most commonly used were nivolumab (86%) and docetaxel (50%), respectively. ORR to single-agent chemotherapy after exposure to anti-PD1 was 39% (11/28 patients, 8 confirmed). In contrast, ORR to first-line chemotherapy in this cohort was 37%. Liver metastasis was the only factor associated with response to single-agent chemotherapy on univariate analysis (p < 0.05). Conclusion In NSCLC patients, the confirmed ORR to single-agent chemotherapy after immunotherapy exposure was higher as compared to historical data from the pre-anti-PD1 era, and approached ORR to first-line platinum-based chemotherapy. Further investigation of a possible immunotherapy-induced chemosensitization effect is warranted.
KW - Checkpoint inhibitors
KW - Chemotherapy
KW - Immunotherapy
KW - Non-small cell lung cancer
KW - PD-1
KW - Response rate
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U2 - 10.1016/j.lungcan.2017.07.034
DO - 10.1016/j.lungcan.2017.07.034
M3 - Article
C2 - 29191606
AN - SCOPUS:85035003179
SN - 0169-5002
VL - 112
SP - 90
EP - 95
JO - Lung Cancer
JF - Lung Cancer
ER -