Outcomes After Progression With Anti-PD-L1, Chemotherapy in mNSCLC Clinical

Patients with metastatic NSCLC (mNSCLC) who receive first-line anti-PD-L1-based IO may achieve durable disease control, but without driver alterations, most will require treatment with additional lines of therapy (LOT). Results from a study that evaluated treatment patterns and real-world clinical outcomes after concurrent or sequential anti-PD-L1 and platinum-doublet chemotherapy (PDC), a setting with currently limited effective options, were presented at the 2023 North America Conference on Lung Cancer.

The study included patients with mNSCLC (without evidence of EGFR/ALK/ROS1 alterations) who experienced disease progression on or after anti-PD-L1 and PDC, initiated subsequent LOT between 2017 and 2021, and had an ECOG PS of 0-2 at LOT initiation (index date). The median patient age was 63 years, 63.1% were male, and 50.4% were White. Most (87.2%) patients had de novo mNSCLC and an ECOG PS of 0-1 (81.6%). Regarding disease progression, 47.5% had liver metastases and 15.6% had brain metastases. The researchers assessed OS and time to treatment discontinuation (TTD) using Kaplan-Meier analysis.

Results showed that most patients had disease progression on anti-PD-L1 and PDC as first-line treatment (90.1%). The most common regimens received as subsequent treatment were nonplatinum chemotherapy (26.2%), anti-PD-L1 monotherapy (18.4%), PDC plus anti-VEGF(R) (9.2%), and nonplatinum chemotherapy plus anti-VEGF(R) (7.1%). The researchers found 6- and 12-month OS rates to be 71.4% and 43.8%, respectively, with a median OS of 9.8 months. Median TTD was 5.8 months.

“Various treatment regimens were used among mNSCLC patients with disease progression after treatment with anti-PD-L1 and PDC. Poor clinical outcomes demonstrate an unmet clinical need that warrants more efficacious treatment options for patients with mNSCLC who progressed on anti-PD-L1 and PDC,” the researchers concluded.

Source: Liu SV, Dasgupta A, Latremouille-Viau D, et al. Real-world clinical outcomes after progression with anti-PD(L)1 and chemotherapy in mNSCLC in the US. Abstract of a poster presented at the 2023 North America Conference on Lung Cancer; December 1-3, 2023; Chicago, Illinois.