EP1.01-53 Update of Mutation Status in Lung Cancer. A Multicenter Local Study

Abstract

Background: Anti-programmed cell death (PD)-1 antibody therapies have shown durable clinical efficacy and manageable toxicity profiles, and have become a standard therapy in advanced non-small cell lung cancer (NSCLC). Because of manageable toxicity profiles, extensive interest in the potential benefits of anti-PD-1 antibody has expanded to high-risk patients such as the elderly or poor performance status (PS) patients. Here, we aimed to investigate predictive markers for the efficacy of anti-PD-1 antibody in elderly patients and poor PS patients. Method: The medical records of 75 years old or PS2 NSCLC patients treated with anti-PD-1 antibody (e.g., nivolumab and pembrolizumab) at the National Cancer Center Japan between December 1, 2015, and May 31, 2018, were reviewed retrospectively. We evaluated the association between efficacy for anti-PD-1 antibody and gender, smoking status, histology, PD-ligand 1(PD-L1) expression on tumor cells, white blood cell counts, lymphocyte counts, albumin, lactate dehydrogenase, c-reactive protein, and serum vascular endothelial growth factor (VEGF). We divided patients into two groups with the median values. Result: A total of 235 patients with advanced NSCLC treated with anti-PD-1 antibody were reviewed. Of these patients, 31 patients were 75 years old, and 22 patients were PS2. The median PFS was 6.9 months in patients aged 75 years and 2.1 months in PS2 patients. Cox proportional hazard regression analysis showed that only the low-VEGF was significantly associated with longer PFS in patients aged 75 years (HR, 0.35; 95% CI, 0.13-0.88; P ¼ 0.025) and in PS2 patients (HR, 0.31; 95% CI, 0.10-0.85; P ¼ 0.023). The overall response rate of patients with low-VEGF was tend to be higher than that with high-VEGF among patients aged 75 years (43% vs. 20%; P ¼ 0.18) and PS2 patients (20% vs. 0%; P ¼ 0.084). Conclusion: Low-VEGF in patients aged 75 years and PS2 patients was associated with longer PFS. Serum VEGF may thus be a biomarker for the efficacy of anti-PD-1 antibody therapy.