Gustavo Schvartsman1, S Andrew Peng2, Giorgios Bis3, J Jack Lee4, Marcelo F K Benveniste5, Jianjun Zhang6, Emily B Roarty7, Lara Lacerda8, Stephen Swisher9, John V Heymach10, Frank V Fossella11, William N William12. 1. Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd, Unit 463., Houston, TX, 77030, USA. Electronic address: gustavoschv@gmail.com. 2. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA. Electronic address: speng1@mdanderson.org. 3. Department of Radiology, Baylor College of Medicine, 6620 Main St, 12th Floor, Suite 1275, Houston, TX, 77030, USA. Electronic address: bis@bcm.edu. 4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA. Electronic address: jjlee@mdanderson.org. 5. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center. 1515 Holcombe Blvd, Room 1478, Houston, TX, 77030, USA. Electronic address: mfbenveniste@mdanderson.org. 6. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 432, Houston, TX, 77030, USA. Electronic address: jzhang20@mdanderson.org. 7. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 432, Houston, TX, 77030, USA. Electronic address: ecbrantley@mdanderson.org. 8. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 432, Houston, TX, 77030, USA. Electronic address: LCAlvarez@mdanderson.org. 9. Department of Thoracic and Cardiovascular Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX, 77030, USA. Electronic address: sswisher@mdanderson.org. 10. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 432, Houston, TX, 77030, USA. Electronic address: jheymach@mdanderson.org. 11. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 432, Houston, TX, 77030, USA. Electronic address: ffossell@mdanderson.org. 12. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 432, Houston, TX, 77030, USA. Electronic address: wnwillia@mdanderson.org.
Abstract
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.
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 NSCLCpatients, 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.
Authors: D Isla; J de Castro; R García-Campelo; P Lianes; E Felip; P Garrido; L Paz-Ares; J M Trigo Journal: Clin Transl Oncol Date: 2019-07-31 Impact factor: 3.405
Authors: A T Freeman; M Lesperance; E S Wai; N S Croteau; L Fiorino; G Geller; E G Brooks; Z Poonja; D Fenton; S Irons; D Ksienski Journal: Curr Oncol Date: 2020-05-01 Impact factor: 3.677
Authors: Giulio Metro; Alfredo Addeo; Diego Signorelli; Alessio Gili; Panagiota Economopoulou; Fausto Roila; Giuseppe Banna; Alessandro De Toma; Juliana Rey Cobo; Andrea Camerini; Athina Christopoulou; Giuseppe Lo Russo; Marco Banini; Domenico Galetta; Beatriz Jimenez; Ana Collazo-Lorduy; Antonio Calles; Panagiotis Baxevanos; Helena Linardou; Paris Kosmidis; Marina C Garassino; Giannis Mountzios Journal: J Thorac Dis Date: 2019-12 Impact factor: 2.895