2022 World Conference on Lung Cancer (ePosters)-EP08.01-075. Combination of Baseline Disease and Smoking Pack-Years Can Guide The 1st-line Treatment Decision in Advanced NSCLC with High PD-L1 Expression

EP08.01-075. Combination of Baseline Disease and Smoking Pack-Years Can Guide The 1st-line Treatment Decision in Advanced NSCLC with High PD-L1 Expression

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A study was conducted to identify factors that can predict disease progression in patients with advanced non-small cell lung cancer (NSCLC) who are receiving first-line pembrolizumab monotherapy. The researchers analyzed the data of 138 patients with stage IIIB/IV NSCLC who had PD-L1 expression of 50% or higher and no EGFR or ALK mutations. The patients received pembrolizumab monotherapy and had baseline computed tomography (CT) scans before treatment initiation and at 9-12 weeks after treatment. The researchers collected information on demographics, smoking history, performance status, tumor pathology, lung tumor size, and the number of organs involved at baseline. Treatment response was assessed using RECIST criteria, and patients were categorized as having progressive disease (PD) or disease control (DC).<br /><br />The results showed that smoking pack-years and the number of involved organs on the baseline CT scan were independently associated with disease progression. Smokers with 40 pack-years or more had a significantly lower risk of progression compared to non-smokers. Additionally, patients with a higher number of organs involved by the disease were more likely to progress. A multivariate model was developed to estimate the patient's risk of disease progression, and patients were classified into high- or low-risk groups based on the model. The model showed good classification performance.<br /><br />The study concludes that patients with a light smoking history and fewer organs involved by the disease have a lower risk of disease progression when receiving pembrolizumab monotherapy. On the other hand, patients with a higher smoking history or more organs involved may benefit from alternative or combination therapies. The proposed model can help guide treatment decisions for patients with advanced NSCLC and high PD-L1 expression. However, further validation studies are needed to confirm these findings.

Asset Subtitle

Ren Yuan

Meta Tag

Speaker Ren Yuan

Topic Metastatic Non-small Cell Lung Cancer - Immunotherapy

Keywords

disease progression

non-small cell lung cancer

NSCLC

pembrolizumab monotherapy

PD-L1 expression

EGFR mutations

ALK mutations

smoking history

tumor pathology

baseline CT scan