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Single centre real life experience with first line pembrolizumab in advanced NSCLC in the North West Coast (Lans and South Cumbria)
Abdulwahid, D. Abutaleb, K Mirza, A.
Abdulwahid, D.
Abutaleb, K
Mirza, A.
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Abstract
Introduction: The clinical-effectiveness evidence for pembrolizumab
came from KEYNOTE-024 trial. Patients included were untreated
stage IV metastatic PD-L1-positive NSCLC, at least 50% PD-L1, no
EGFR- or ALK-positive mutations and a performance status of 0-1.
PEMBRO was associated with significantly longer progression free
and overall survival and with fewer adverse events. The aim was to
compare our cohort with the profile of PEMBRO patients observed
in the trial and to assess toxicity outcomes for our NSCLC patients
on first-line PEMBRO.
Methods: Restrosepective data of NSCLC patients, commenced on
pembrolizumab between June 2016 and October 2017, was collected.
149 patients were screened.16 were duplicated therefore excluded.
A further 64 on 2nd+ line pembrolizumab were excluded. 69 patients
were included in the final analysis.
Results: Our cohort (n=69) were diagnosed between March 2015
and September 2017. Its characteristics are shown in Table 1. Median
duration between availability of tumor propotion score and the
first cycle of pembrolizumab was 1.2 week (range 1-4). Median
duration of treatment was 23.4 weeks (range 3-81). Best response
was Complete response in 2 (2.9%), partial response in 29 (42%) and
stable disease in 17 (24.6%) patients. 15.9% patients died shortly
after starting their treatment and no imaging data available to
assess response. At time of analysis, 26 were dead and 43 were still
alive. 10.1% continued on treatment beyond progression. Time from
commencing PEMBRO to progression ranged 0.8 to 17.8 + months,
median not reached. 40 (57.9%) had treatment deferrals; 55% due
to pneumonia, 10% due to colitis, 7.5% due to pneumonitis, 7.5%
patient choice. 1 (2.5%) nephropathy, 1 (2.5%) neuropathy and 1
(2.5%) transaminitis. 21 patients had steroids and 1 mycophenolate
for immune related toxicities (30.4%, 2.5%). Conclusion: Our response rates and toxicity data were comparable
to Keynote-024. Discrepancies can be explained by the number of
the cohort and the retrospective nature of data.
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Description
Date
2019
Publisher
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Type
Meetings and Proceedings
Citation
Abdulwahid D, Abutaleb K, Mirza A. Single centre real life experience with first line pembrolizumab in advanced NSCLC in the North West Coast (Lans and South Cumbria). Lung Cancer. 2019;127:S45-S.