WCLC 2025 - Posters & ePosters-EP.11.17 Promising Effect of Nivolumab With Carboplatin, Paclitaxel, and Bevacizumab in EGFR-Mutant NSCLC Following EGFR-TKI Therapy

EP.11.17 Promising Effect of Nivolumab With Carboplatin, Paclitaxel, and Bevacizumab in EGFR-Mutant NSCLC Following EGFR-TKI Therapy

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Pdf Summary

This single-center retrospective cohort study evaluated the clinical efficacy and safety of nivolumab combined with carboplatin, paclitaxel, and bevacizumab (NBCP) versus atezolizumab combined with the same chemotherapy and bevacizumab (ABCP) in patients with advanced EGFR-mutated non-small cell lung cancer (NSCLC) who progressed after EGFR-tyrosine kinase inhibitor (TKI) therapy. The study included 31 patients treated between 2019 and 2024 at Sendai Kousei Hospital.<br /><br />Results demonstrated that NBCP achieved a numerically longer median progression-free survival (PFS) of 8.7 months compared to 4.4 months with ABCP (hazard ratio [HR] 0.48, p=0.07), and overall survival (OS) of 23.4 months versus 9.9 months with ABCP (HR 0.53, p=0.19), though these differences did not reach statistical significance. NBCP also showed higher objective response rate (ORR) of 61.5% and disease control rate (DCR) of 100%, compared to ORR 38.9% and DCR 88.9% with ABCP. Safety profiles were manageable and similar across both regimens, with expected hematological and non-hematological toxicities.<br /><br />Subgroup analyses suggested NBCP might offer greater benefit in patients aged 65 or older, males, smokers, and those receiving second-line therapy, while ABCP may benefit patients with liver metastases; however, these findings were exploratory due to limited sample size. Immune modulation and synergistic effects from combining PD-1 inhibitors, anti-VEGF therapy, and chemotherapy likely contribute to the observed efficacy of NBCP.<br /><br />Overall, NBCP demonstrated comparable or better clinical outcomes than ABCP post-EGFR-TKI failure with acceptable toxicity, supporting its potential as a promising treatment option. The authors recommend prospective multicenter trials to validate these findings given the study's retrospective design and small cohort.

Asset Subtitle

Akane Narumi

Meta Tag

Speaker Akane Narumi

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

nivolumab

atezolizumab

carboplatin

paclitaxel

bevacizumab

EGFR-mutated non-small cell lung cancer

tyrosine kinase inhibitor resistance

progression-free survival

overall survival

immune checkpoint inhibitors