Single centre real life experience with first line pembrolizumab in advanced NSCLC in the North West Coast (Lans and South Cumbria)
AffiliationClinical Oncology, Royal Preston Hospital, United Kingdom
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AbstractIntroduction: 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.
CitationAbdulwahid 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.
TypeMeetings and Proceedings