2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.11A.05 Use of Immune Checkpoint Inhibitors in Advanced NSCLC Cases with Very Poor ECOG-PS: A Real World Experience.

EP.11A.05 Use of Immune Checkpoint Inhibitors in Advanced NSCLC Cases with Very Poor ECOG-PS: A Real World Experience.

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This study explores the real-world application of immune checkpoint inhibitors (ICI) in patients with advanced non-small cell lung cancer (NSCLC) who have a very poor Eastern Cooperative Oncology Group Performance Status (ECOG-PS 3/4). Such patients are typically excluded from clinical trials, leaving a gap in available safety and efficacy data. Traditional chemotherapy is often not a viable option due to their poor performance status, thereby limiting treatment alternatives.<br /><br />The study includes data collected from September 2022 to March 2024, assessing NSCLC patients with stage IIIB or higher and performance statuses of 3 or 4. Key exclusions were patients with targetable genetic alterations, ongoing brain radiotherapy, or spinal cord metastasis that limits care. The study found that the majority of patients were male (83.3%), smokers (79.2%), with COPD (62.5%), and squamous cell histology (66.7%). The median age was 61.7 years.<br /><br />Results showed that the most common ICIs used were nivolumab (70.8%) and atezolizumab (29.2%). Over approximately 48 weeks of follow-up, 58.3% of patients showed disease progression, and 33.3% died. The median progression-free survival (PFS) was 24 weeks, while overall survival (OS) was 44 weeks. About 25% achieved partial remission, and 45.8% had stable disease. Safety assessments revealed side effects like hypothyroidism, pneumonitis, and transaminitis in some patients.<br /><br />No significant differences in PFS or OS were observed when stratified by factors such as disease stage, histology, and treatment lines. However, some patients (8 out of 24) experienced an improvement in performance status. Despite certain adverse effects, ICIs showcased potential as a relatively safe alternative to chemotherapy, serving as an additional option to best supportive care for this challenging patient subgroup.

Asset Subtitle

Pawan Singh

Meta Tag

Speaker Pawan Singh

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

immune checkpoint inhibitors

non-small cell lung cancer

ECOG-PS 3/4

clinical trials exclusion

treatment alternatives

nivolumab

atezolizumab

progression-free survival

overall survival

safety assessment