2SPD-012 Immunotherapy in patients with non-small cell lung cancer: effectiveness and safety in real life

Background and importanceThe high cost of immunotherapy makes it necessary to assess health outcomes in real life, which can help in decision-making.Aim and objectivesThe current study aimed to analyse the effectiveness and safety of immunotherapy in second-line treatment in adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) in real life.Material and methodsRetrospective and observational study. All patients with locally advanced or metastatic NSCLC treated with nivolumab, pembrolizumab and atezolizumab monotherapy as second-line treatment between April 2017 and April 2020 were included.Outcomes collected were: demographic variables: age and sex and clinical variables: diagnosis, stage, performance status score according to Eastern Cooperative Oncology Group (ECOG), PD-L1 expression and treatment variables: treatment start and end date and administered doses.The primary endpoints were: overall survival (OS) and progression-free survival (PFS). All adverse effects (AE) were recorded according to CTCEA v4.3 criteria.Data were collected from the electronic clinical history and electronic prescribing software. The Kaplan−Meier method was used to calculate PFS and OS. SPSS v17 was used to perform statistical calculations.Results104 patients were included in this study: N=40 nivolumab, N=29 pembrolizumab and N=35 atezolizumab. Median age was 62.93±9.20, 64.92±11.69 and 59.86±11.60 years, respectively. 74.7% were men and 67.8% were ECOG-1.Nivolumab showed an OS of 6.4 months (95% CI 2.81 to 9.98) and a PFS of 3 months (95% CI 1.14 to 4.25), pembrolizumab-treated patients had a median OS of 8 months (95% CI 3.05 to 12.94) and median PFS of 3.5 months (95% CI 2.4 to 4.6). The use of atezolizumab demonstrated an OS of 6.33 months (95% CI 4.4 to 9.1) with a PFS of 3.2 months (95% CI 2.6 to 7.2).82.5% of patients suffered from some AE to nivolumab, 76.9% to pembrolizumab and 80.9% to atezolizumab. Asthenia was the AE that occurred most frequently and was common to all three drugs.Conclusion and relevanceSafety was similar for all drugs, and the effectiveness in terms of OS was a little higher for pembrolizumab, which could be related to the fact that patients treated with this antibody had PD-L1 expression >1%. However, it will be necessary to expand the sample size to generate quality information that can help in decision-making in real-life clinical practice.References and/or acknowledgementsConflict of interestNo conflict of inter