Real-world outcomes of immunotherapy regimens in first line non small cell lung cancer in lebanese patients.

e18741 Background: Immunotherapy provides improved treatment efficacy and survival in NSCLC patients. This is well established from clinical trials. However, the effectiveness of immunotherapy in real world practice is not well assessed. We aimed to characterize real-world outcomes for patients with NSCLC treated with 1L I-O in Lebanon. Methods: Patients aged ≥18 years with confirmed metastatic NSCLC who received either 1L I-O monotherapy or single-agent I-O combined with chemotherapy on or after January 1, 2014. Primary objectives were to examine overall survival (OS) and real-world progression-free survival. Multivariable analysis were made on correlation of different factors and survival. Results: among 135 patients, Median age at diagnosis was 68 years Most patients received chemotherapy alone as first line(54%), 18.3 % received immunotherapy and 27.8% received the combination treatment of chemotherapy and immunotherapy. Median PFS 1 was 7.7, 14, 11.1 months for chemotherapy, immunotherapy and chemo-immunotherapy respectively (p = 0.062). Median OS was 22.9 months (CI 95%, 17.7-28.1) with no significant correlation with treatment type (p = 0.85) multivariate analysis showed that having PDL levels between 1 and 49 (HRa = 0.15) and ≥50 (HRa = 0.12) compared to < 1 were significantly associated with longer PFS period, whereas having squamous (HRa = 3.45) and other (HRa = 27.36) type of cancer compared to adenocarcinoma was significantly associated with shorter PFS period. (HRa = 3.28) was significantly associated with lower overall survival period (p = 0.10).Concerning adverse effects, rash was the most frequent (14%) followed by pneumonitis (12.2%). Conclusions: In real world practice, IO was well tolerated in lebanese patients. Patients with high (≥50) and intermediate (between 1 and 49) tumor programmed death ligand 1 (PD-L1) expression demonstrated longer median OS vs those with low expression. We hypothesize that bone metastasis impairs immunotherapy efficacy.