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31.08.2018 | Original Article | Ausgabe 12/2018

Cancer Immunology, Immunotherapy 12/2018

Organ-specific response to nivolumab in patients with non-small cell lung cancer (NSCLC)

Zeitschrift:
Cancer Immunology, Immunotherapy > Ausgabe 12/2018
Autoren:
Sabine Schmid, Stefan Diem, Qiyu Li, Mirjam Krapf, Lukas Flatz, Sebastian Leschka, Lotus Desbiolles, Dirk Klingbiel, Wolfram Jochum, Martin Früh
Wichtige Hinweise
The abstract was already presented as a Poster at the IASLC 18th World Conference on Lung Cancer (WCLC) in Yokohama, Japan, 15–18.10.2017.
Sabine Schmid and Stefan Diem contributed equally as first authors.

Abstract

Background

Response to immune checkpoint inhibitors depends on tumor intrinsic properties and also on host factors in the tumour microenvironment including the presence of immune cells (IC). We hypothesized that nivolumab efficacy varies across different metastatic sites.

Methods

We retrospectively analyzed computed tomography scans of patients with metastatic non-small cell lung carcinoma (NSCLC) receiving nivolumab. RECIST 1.1 criteria were applied to assess the overall response rate (ORR) and organ-specific response rate (OSRR).

Results

We analyzed 52 patients including 44% females, 58% adenocarcinoma and 8% never smokers. Involved organs had target-lesions in the lung (42%), liver (25%), lymph nodes (56%) and soft tissue (13%) and non-target lesions in the bones (23%). ORR and disease control rate (DCR) were 20% and 45%, respectively. Median overall survival, progression-free survival and duration of response were 11.9, 2.3 and 10.3 months. OSRR and organ-specific DCR (OSDCR) were 28% and 90% in lymph nodes, 8% and 54 in the liver, and 9% and 55% in lung metastases. Nine out of 12 patients with bone metastases had progressive lesions. The cumulative incidence probability of organ-specific progression at 6 months was 14% in lymph nodes, 42% in the liver, 36% in lung metastases and 26% in the primary tumor, 29% in soft tissue and 33% in adrenal metastases.

Conclusion

In conclusion, the efficacy of immunotherapy is dependent on the metastatic location. Treatment appears more active in lymph nodes compared to other organ sites such as liver, adrenals and bone. Future strategies may include additional local treatment in case of oligoprogression in these organs in patients with otherwise sustained treatment benefit.

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