2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.11A.13 Efficacy and Safety of Immune-Checkpoint Inhibitors in Advanced NSCLC Patients with Rare Mutation after Developing Targeted Therapy Resistance

EP.11A.13 Efficacy and Safety of Immune-Checkpoint Inhibitors in Advanced NSCLC Patients with Rare Mutation after Developing Targeted Therapy Resistance

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This study investigates the efficacy and safety of immune-checkpoint inhibitors (ICIs) in treating advanced non-small cell lung cancer (NSCLC) patients with rare mutations who have developed resistance to targeted therapies. The research involved analyzing data from 375 NSCLC patients treated at Shanghai Chest Hospital between June 1, 2018, and December 31, 2022. These patients had rare oncogenic driver mutations such as EGFR rare mutations, ALK and ROS1 rearrangements, c-MET amplification or exon 14 skipping, and BRAF V600E mutation.<br /><br />The median follow-up period was approximately 25.1 months. The majority of mutations included EGFR rare mutations (37.6%), ALK rearrangements (28.5%), and ROS1 rearrangements (22.9%). The study found that excluding patients with ALK rearrangements, those treated with immunotherapy showed improved overall survival (OS) and progression-free survival (PFS) compared to those receiving other treatments, with median OS at 31.3 months versus 23.5 months and median PFS at 9.2 months versus 4.9 months.<br /><br />Despite the general effectiveness of ICIs, the high-level expression status of PD-L1 was not correlated with better PFS in patients who developed resistance to targeted therapies. Among the patients with available data, 8.8% experienced significant adverse events (AEs), classified as grade 3 to 5.<br /><br />The findings suggest that ICI-based treatments may offer better survival outcomes for NSCLC patients with rare mutations after developing resistance to targeted therapy, except for those with ALK rearrangements who may continue to benefit more from targeted therapies. However, the prognosis for these patients is not significantly related to PD-L1 expression status. The study highlights the need for continued research into tailored treatment approaches for NSCLC patients with rare genetic profiles.

Asset Subtitle

Wei Zhang

Meta Tag

Speaker Wei Zhang

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

immune-checkpoint inhibitors

advanced non-small cell lung cancer

rare mutations

targeted therapies resistance

EGFR mutations

ALK rearrangements

ROS1 rearrangements

c-MET amplification

BRAF V600E mutation

PD-L1 expression