Immunotherapy less effective in NSCLC with bone metastases

  • Landi L & al.
  • J Immunother Cancer
  • 21 Nov 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Immunotherapy with immune checkpoint inhibitors (ICIs) was less effective in patients with NSCLC and bone metastases than in those without bone metastases, regardless of tumor histology.

Why this matters

  • Up to 30% of patients with NSCLC have bone metastases at NSCLC diagnosis, and another 35%-40% develop the lesions after diagnosis.

Study design

  • Pretreated patients with nonsquamous NSCLC (n=1588) and squamous NSCLC (n=371) in the Italian Expanded Access Program were evaluated for nivolumab efficacy according to bone metastases.
  • Funding: None.

Key results

  • 39% of nonsquamous patients and 32% of squamous patients had bone metastases.
  • Nonsquamous patients with bone metastases had a significantly lower objective response rate (ORR; 12% vs 23%; P<.0001 and pfs vs months p os>
  • Squamous patients with bone metastases also had significantly lower ORR (13% vs 22%; P=.04) and shorter PFS (2.7 vs 5.2 months; P<.0001 os vs months p>
  • After multivariable analysis, bone metastases were associated with higher mortality (nonsquamous HR, 1.50 [P<.0001 and squamous hr pfs orr>

Limitations

  • Retrospective study.