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Observational Study
. 2020 Sep;21(5):389-394.e3.
doi: 10.1016/j.cllc.2020.04.008. Epub 2020 Apr 18.

Real-World Outcomes for Advanced Non-Small Cell Lung Cancer Patients Treated With a PD-L1 Inhibitor Beyond Progression

Thomas E Stinchcombe  1 , Rebecca A Miksad  2 , Anala Gossai  2 , Sandra D Griffith  2 , Aracelis Z Torres  3
Affiliations
Observational Study

Real-World Outcomes for Advanced Non-Small Cell Lung Cancer Patients Treated With a PD-L1 Inhibitor Beyond Progression

Thomas E Stinchcombe et al. Clin Lung Cancer. 2020 Sep.

Abstract

Background: Clinical trials of anti-programmed cell death ligand 1 (PD-L1) inhibitor to treat advanced non-small-cell lung cancer (aNSCLC) have permitted treatment beyond progression (TBP). However, the outcomes of patients receiving TBP in routine clinical care are unknown.

Materials and methods: The present retrospective, observational, multicenter analysis evaluated de-identified electronic health record-derived data from community-based clinics in the United States. The patients had confirmed aNSCLC, had started anti-PD-L1 inhibitor therapy (nivolumab, pembrolizumab, or atezolizumab) before October 1, 2018, and had experienced a real-world progression (rwP) event. The study period ended March 31, 2019. The primary objective was to compare the overall survival (OS) of patients who had discontinued immunotherapy ≤ 30 days (non-TBP) compared with > 30 days after rwP (TBP). Descriptive analyses were performed. The Kaplan-Meier method and log-rank test were conducted for OS. An adjusted multivariable Cox proportional hazards regression model was also used.

Results: Overall, the data from 4223 patients were analyzed; 2555 (60.5%) and 1668 (39.5%) in the non-TBP and TBP cohorts, respectively. The median treatment duration for the non-TBP and TBP patients was 2.8 and 9.1 months (log-rank test, P < .001), respectively. The TBP group experienced longer unadjusted OS compared with the non-TBP group (11.5 vs. 5.1 months; log-rank test, P < .001). After adjusting for clinically relevant patient characteristics, the TBP OS benefit persisted (adjusted hazard ratio, 0.69; P < .001).

Conclusions: TBP with PD-L1 inhibitor therapy is common in aNSCLC routine care and is potentially effective. These results support clinical trial observations likely to affect practice patterns.

Keywords: Immuno-oncology; NSCLC; Treatment after progression.

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