2022 World Conference on Lung Cancer (ePosters)-EP08.01-043. Clinicopathologic and Genomic Factors Impacting Efficacy of First-Line Chemoimmunotherapy in Advanced Non-small Cell Lung Cancer (NSCLC)

EP08.01-043. Clinicopathologic and Genomic Factors Impacting Efficacy of First-Line Chemoimmunotherapy in Advanced Non-small Cell Lung Cancer (NSCLC)

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This study aimed to identify the clinicopathologic and genomic factors that impact the efficacy of first-line chemoimmunotherapy (CIT) in advanced non-small cell lung cancer (NSCLC). The researchers conducted a multicenter retrospective analysis, collecting clinicopathologic and genomic data from patients with metastatic NSCLC who did not have sensitizing genomic alterations in EGFR and ALK. <br /><br />The results showed that several factors were associated with improved clinical outcomes to first-line CIT. These factors included better patient performance status, low derived neutrophil-to-lymphocyte ratio (dNLR), increasing PD-L1 expression, a high tumor mutational burden (TMB), and wild-type status of the STK11/KEAP1 genes. These findings have implications for the initial treatment selection for NSCLC patients.<br /><br />Among the patients treated with CIT, a worsening performance status and increasing dNLR were associated with lower overall response rate (ORR), shorter median progression-free survival (mPFS), and shorter median overall survival (mOS). Higher PD-L1 tumor proportion scores (TPS) were correlated with better ORR, mPFS, and OS. Similarly, NSCLCs with higher TMB had improved ORR, mPFS, and OS compared to those with lower TMB. In KRAS-mutant NSCLC, co-occurring mutation in STK11 or KEAP1 was associated with worse mPFS and mOS to CIT. Among KRAS wild-type NSCLC, KEAP1 mutation was linked to shorter mPFS and mOS to CIT, while STK11 mutation did not have a significant impact.<br /><br />In summary, this study identified several clinicopathologic and genomic factors that influence the efficacy of first-line CIT in advanced NSCLC. These findings can help guide treatment selection and improve outcomes for NSCLC patients.

Asset Subtitle

Joao Alessi

Meta Tag

Speaker Joao Alessi

Topic Metastatic Non-small Cell Lung Cancer - Immunotherapy

Keywords

clinicopathologic factors

genomic factors

efficacy

first-line chemoimmunotherapy

advanced non-small cell lung cancer

metastatic NSCLC

patient performance status

tumor mutational burden

KRAS mutation

treatment selection