Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Real-world experience of nivolumab monotherapy in advanced non-small cell lung cancer (NSCLC): Retrospective analysis from a large tertiary centre (#355)

Ajay Raghunath 1 , Obaid Fazli 1 , Ben Markman 1
  1. Oncology, Monash Health, Clayton, VIC, Australia

Aims: Previously published clinical trials established the use of the PD1 inhibitor nivolumab in the second line treatment of Eastern cooperative oncology group (ECOG) 0/1 advanced NSCLC patients. We aimed to analyse the outcomes of nivolumab in a diverse real-world population.

Methods: Patient data was collected from a single large tertiary centre using pharmacy records. All patients who received at least one dose of single agent nivolumab for stage III/IV NSCLC over a 28-month period were included. The primary outcome was overall survival (OS) stratified by age, ECOG and line of therapy.

Results: 46 patients were identified. Median age was 67 years. Demographics included 29 (63%) male, 35 (76%) non-squamous NSCLC, 40 (86%) stage IV, 6 (13%) EGFR mutant and 38 (83%) ECOG 0/1 patients. Eighteen (40%) patients had received 2 or more prior lines of treatment, 6 (13%) had prior resection and 16 (35%) had prior definitive chemoradiotherapy. Best response to nivolumab was PR/SD/PD for 4%/36%/54% of patients respectively. Median OS for the entire cohort was 8.3 months. Median OS was 8.3 months and 8.2 months in ECOG 0/1 and ECOG 2 patients respectively. Median OS was higher in patients receiving nivolumab 2nd line versus 3rd line or later, 12.5 and 5.0 months respectively. Median OS was similar for patients <75 and ≥75 years, 8.3 months and 7.8 months respectively.

Conclusions: Based on this data from a single tertiary centre, survival outcomes with nivolumab in the treatment of advanced NSCLC appeared to be maintained in patients with a poorer performance status (ECOG 2) or aged 75 years or older. There was a trend towards lower median OS in 3rd or later lines of therapy. Response rates were lower than published data, potentially due to nivolumab use in later lines of treatment.