EP1.01-32 Improving the Prognosis of Non-Small Cell Lung Cancer After the Approval of Immune Checkpoint Inhibitors: A Retrospective Analysis

Anti-programmed death-1/programmed death-ligand-1 (PD-1/PD-L1) blockade represents a revolutionary breakthrough in the treatment of advanced non-small-cell lung cancer (NSCLC). However, it remains unclear whether the immunotherapy for PD-1 axis are associated with overall survival (OS) in real world patients. We retrospectively analyzed consecutive 246 patients with stage IIIB or IV NSCLC who underwent at least 1 regimen of chemotherapy. Patients who have EGFR mutations, ALK/ROS1 rearrangements, or received curative thoracic radiotherapy were excluded. Besides, patients administered any immune checkpoint inhibitors in clinical trials were also excluded. Treatment outcomes were compared between patients who started chemotherapy from January 2012 to December 2014 (cohort A; n=135) and those who started it from January 2016 to December 2017 (cohort B; n=111). Baseline characteristics were balanced using propensity score matching, including variables such as age, sex, performance status (PS), histology, clinical stage, bone metastases, central nervous system (CNS) metastases, liver metastases, pulmonary metastases, and pleural dissemination. Median OS was 11.4months in cohort A and 16.6mo in cohort B (HR 0.68, 95%CI 0.50-0.93, P=0.016). In 111 propensity-score matching pairs, median OS was 11.2months in cohort A and 16.6months in cohort B (HR 0.68, 95%CI 0.49-0.94, P=0.021), and the 12-month OS rate was 48.7% in cohort A versus 59.9% in cohort B, respectively. PD-1 axis inhibitors were received 13.5% in cohort A and 64.9% in cohort B. Forest plot for the propensity-matched patient analysis demonstrated a significantly better outcome in cohort B, for patients with PS 0 to 1, smokers, number of metastases ≤1, no bone metastases, no CNS metastases, no liver metastases, no pulmonary metastases, pleural metastases, and squamous histology. This result indicates the appearance of immunity checkpoint inhibitors improved the prognosis of driver-mutation negative NSCLC in real world.