Clinical responses and survival in Hispanic patients with non-small cell lung cancer treated with immunotherapy compared with non-Hispanic whites.

Abstract

e18109 Background: The main immunotherapy (IMMUNO) trials that led to the approval of these agents for non-small cell lung cancer (NSCLC) accrued a minimum number of Hispanic (HISP) patients (pts) or, in some studies, no HISP pts at all. Additional data is thus needed to validate outcomes in HISP pts with NSCLC treated with IMMUNO. While it is known that genomic profiles and cancer survivals are different between HISP, Non-Hispanic Whites (NHW), and African-Americans; no study has yet looked at differences in IMMUNO outcomes between these populations. Methods: We present data in 436 NSCLC pts treated with IMMUNO at 5 large institutions (3 in the US, 2 in Latin America). The agents evaluated include: nivolumab, pembrolizumab and atezolizumab. 256 pts were HISP and 180 pts were NHW. Most of the pts were treated with single agent therapy as second line (or beyond) while a small group of pts were treated as first line. The primary endpoints of the study were: response rate (ORR), progression free survival (PFS) and overall survival (OS). Results: Among NHW pts, disease control rate (DCR) was 67% for Adenocarcinomas (Adeno) and 46% for squamous cell carcinomas (SQCC). In HISP pts there were no differences in DCR rates between both histologies: 68% for Adeno and 67% SQCC. There were no statistical significant differences among HISP and NHW pts regarding ORR, PFS, OS, and responses according to PD-L1 status. Conclusions: This is the largest publication and comparison of NSCLC immunotherapy outcomes in HISP vs NHW pts. No significant differences were found in the clinical outcomes between these 2 ethnic groups despite expected genomic differences. Pts with actionable mutations were excluded as they usually do not get IMMUNO as first or second line; an approach that might change after IMPOWER 150. These results are comparable to the ones seen in Checkmate and Keynote studies. As expected, higher response rates were seen in first line therapy and pts with PD-L1 (+) status. Further comparisons will be better addressed by a larger prospective study.[Table: see text]

Lung Cancer Disparities in Hispanics: Molecular Diagnosis and Use of Immunotherapy

“…Likewise, if we consider the main outcomes to immunotherapy in NSCLC, most of the CheckMate and KEYNOTE trials were done in the United States and Europe, and they did not include or included a minimal number of Hispanics. Recently, Raez et al 25 reported information from 256 Hispanic patients with NSCLC treated with immunotherapy (mainly as second-line therapy) in Argentina, Peru, and the United States (Miami). In parallel, the authors matched these data with 180 NHW controls, finding no difference in outcomes (progression-free survival [PFS] and overall survival [OS]) at 4 and 22 months.…”

Challenges in Genetic Testing and Treatment Outcomes Among Hispanics With Lung Cancer

“…If we consider the outcomes to immunotherapy in NSCLC, most of the registration trials were done in the United States and Europe, and they did not include anybody or enrolled a minimal number of Hispanics. Raez et al 36 reported data from 256 Hispanics with NSCLC treated with single-agent immunotherapy as second-line in LATAM and the United States. These data were compared with 180 NHW controls, finding no difference in outcomes (PFS and OS).…”