Anti-PD-(LI) therapy combined with chemotherapy may improve efficacy outcomes compared to immunotherapy alone in most subgroups of patients with advanced NSCLC with PD-L1 score 1-49%, according to an exploratory pooled analysis recently presented at ASCO.  

According to the data presented by Oladimeji Akinboro, MD, MPH, at the Department of Medicine, Montefiore New Rochelle Hospital in New York, patients 75 and over experienced similar outcomes across therapeutic options. 

According to the abstract, immunotherapy (IO) + chemotherapy ± anti-angiogenics comprise FDA-approved 1L regimens for metastatic NSCLC, with IO-only therapy approved only for PD-L1-positive NSCLC. While patients with PD-L1 scores 1-49% have many therapeutic options, little is known about how subgroups of patients experience benefit across treatment regimens, the researchers wrote. 

To further explore the effects of treatment on this patient set, Akinboro and colleagues pooled data from 8 randomized controlled trials, investigating anti-PD-(L)1 therapy as IO-only or in chemo-IO regimens for the 1L treatment of patients with advanced NSCLC.  

The researchers defined PD-L1 score as the proportion of tumor cells stained by the assay, and conducted analysis for patients whose tumors had PD-L1 score 1-49%. Tumor-infiltrating immune cell staining was not considered.  

They compared overall survival and progression-free survival between chemo-IO and IO alone via a pooled analysis of 2,108 patients with NSCLC and PD-L1 score 1-49.  

Baseline characteristics were: 37% aged 65-74 years and 12% aged ≥75; 67% male; 79% white; 65% ECOG ≥ 1; and 85% smokers and the analysis had a median follow-up was 12.1 months.  

Patients receiving chemo-IO (N=639) had longer PFS and OS compared to patients treated with IO alone (N=529), with median PFS 7.7 vs 4.2 months (HR 0.60; 95% CI 0.48, 0.76) and median OS 21.4 vs 14.5 months (HR 0.68; 95% CI 0.52, 0.90).  

While the study suggests improved efficacy outcomes, all results presented in the abstract are considered exploratory and hypothesis generating, according to researchers.  


By Dave Quaile, /alert Contributor