PREDICTIVE AND PROGNOSTIC SIGNIFICANCE OF TUMOR LOCATION IN NON-SMALL CELL LUNG CANCER PATIENTS TREATED WITH ANTI-PD-1 THERAPY

TYPE: Abstract Publication TOPIC: Lung Cancer PURPOSE: Immunotherapy targeting programmed cell death-1 (PD-1) has become one of the standard pharmacological therapies. Although tumor mutation burden level was reported to depend on the tumor location in non-small cell lung cancer (NSCLC), predictive impact of the tumor location on the response to anti-PD-1 therapy is unknown in NSCLC patients. METHODS: Two hundred and seventeen advanced or recurrent NSCLC patients treated with anti-PD-1 therapy at Kyushu University Hospital and National Hospital Organization Kyushu Cancer Centerwere analyzed. To minimize the bias arising from the patients’ background, adjusted Kaplan-Meier survival curves and Cox proportional hazards regression analyses using inverse probability of treatment weights (IPTW) were performed. RESULTS: Of the 217 patients, 132, 27, and 58 had NSCLC in upper, middle, and lower lobes, respectively. Patients with NSCLC in upper lobe were significantly associated with younger age (P= 0.0070) and smoker (P= 0.0003). Overall response rate of NSCLC in upper lobes was significantly higher than that in middle/lower lobes (34.1% vs 17.7%; P= 0.0070). The IPTW-adjusted Kaplan-Meier curves showed that patients with NSCLC in upper lobes had significantly longer progression-free survival (PFS) and overall survival (OS) than those in middle/lower lobes (P= 0.0026 and P= 0.0015, respectively). On IPTW adjusted Cox analysis, NSCLC in upper lobe was an independent predictor of PFS and OS (P= 0.0078 and P= 0.0034, respectively). CONCLUSIONS: Responses to anti-PD-1 therapy differed according to the tumor location in NSCLC. These findings should be validated prospectively with a larger sample size. CLINICAL IMPLICATIONS: Patients with NSCLC in upper lobes may be a good candidate for anti-PD-1 therapy. DISCLOSURE: No significant relationships. KEYWORDS: pulmonary lobe, NON-SMALL CELL LUNG CANCER, programmed cell death-1