Predictive and prognostic clinical and pathological factors of nivolumab efficacy in non-small-cell lung cancer patients

• J. Garde-Noguera ^[1] ; P. Martin-Martorell ^[9] ; M. De Julián ^[10] ; J. Perez-Altozano ^[11] ; C. Salvador-Coloma ^[12] ; J. García-Sanchez ^[1] ; A. Insa-Molla ^[9] ; M. Martín ^[13] ; X. Mielgo-Rubio ^[2] ; S. Marin-Liebana ^[3] ; A. Blasco-Cordellat ^[4] ; S. Blasco-Molla ^[5] ; R. Gironés ^[6] ; D. Marquez-Medina ^[1] ; F. Aparisi ^[7] ; M. C. Bas Cerda ^[8] ; S. Macia-Escalante ^[14] ; A. Sánchez ^[10] ; O. Juan-Vidal ^[12]
  1. [1] Hospital Arnau de Vilanova

     Hospital Arnau de Vilanova

     Valencia, España

     
  2. [2] Fundación Hospital Alcorcón

     Fundación Hospital Alcorcón

     Alcorcón, España

     
  3. [3] Hospital de Manises

     Hospital de Manises

     Valencia, España

     
  4. [4] Hospital General Universitario de Valencia

     Hospital General Universitario de Valencia

     Valencia, España

     
  5. [5] Hospital de Sagunto

     Hospital de Sagunto

     Sagunto/Sagunt, España

     
  6. [6] Hospital Xàtiva Lluis Alcanyis

     Hospital Xàtiva Lluis Alcanyis

     Játiva, España

     
  7. [7] Hospital Virgen de los Lirios

     Hospital Virgen de los Lirios

     Alcoy, España

     
  8. [8] Universidad Politécnica de Valencia

     Universidad Politécnica de Valencia

     Valencia, España

     
  9. [9] University Hospital Clínic de Valencia
  10. [10] Hospital Provincial de Castellón
  11. [11] Hospital General de Elche
  12. [12] Hospital Universitari I Politècnic La Fe
  13. [13] Hospital Dr Peset
  14. [14] Pivotal CRO, Madrid

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 20, Nº. 8, 2018, págs. 1072-1079
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Background Immunotherapy increases overall response rate (ORR) and overall survival (OS) in patients with non-small-cell lung cancer (NSCLC). Prognostic and predictive factors are a high need.

    Patients and methods Retrospective review of NSCLC patients treated with nivolumab was performed. Analyzed variables included age, sex, stage, performance status (PS), location of metastases, presence of tumour-related symptoms and comorbidities, number of metastasis locations, previous chemotherapy, anti-angiogenic and radiotherapy treatments, and analytical data from the standard blood count and biochemistry.

    Results A total of 175 patients were included. Median age was 61.5 years, 73.1% were men, 77.7% were ECOG-PS 0–1, and 86.7% were included with stage IV disease. Histology was non-squamous in 77.1%. Sixty-five received nivolumab in second line (37.1%). Thirty-eight patients had brain metastasis (22%), and 39 (22.3%) liver metastasis and 126 (72%) had more than one metastatic location. The ORR was 15.7% with median Progression free survival (PFS) 2.8 months and median OS 5.81 months. Stage III vs IV and time since the beginning of the previous line of treatment ≥ 6 vs < 6 months were associated with better response. PS 2, time since the previous line of treatment < 6 vs ≥ 6 months, and more than one metastatic location were independently associated with shorter OS in multivariable analysis (7.8 vs 2.7 months, 11.2 vs 4.6 months, and 9.4 vs 5.1 month). Finally, time since the previous treatment < 6 vs ≥ 6 months and more than one metastatic location were independently associated with shorter PFS in multivariable analysis (4.3 vs 2.3 months and 4.7 vs 2.3 months).

    Conclusion Poor PS, short period of time since the previous treatment, and more than one metastatic location were associated with poorer prognostic.