Efficacy of nintedanib and docetaxel in patients with advanced lung adenocarcinoma treated with first-line chemotherapy and second-line immunotherapy in the nintedanib NPU program.
Por:
Corral, J, Majem, M, Rodriguez-Abreu, D, Carcereny, E, Cortes, A, Llorente, M, Picazo, J, Garcia, Y, Domine, M and Criado, M
Publicada:
1 sep 2019
Ahead of Print:
15 feb 2019
Resumen:
PURPOSE: Both nintedanib/docetaxel and anti-PD-1/PD-L1 immunotherapies have demonstrated efficacy as second-line treatment of patients with advanced lung adenocarcinoma. This is the first report on the efficacy of the nintedanib/docetaxel combination following first-line platinum-based chemotherapy and subsequent immunotherapy in a real-world setting. METHODS/PATIENTS: From May 2014 to December 2015, 390 patients in 108 Spanish centres enrolled in the nintedanib named patient use program. Inclusion criteria were advanced lung adenocarcinoma with progressive disease following at least one line of platinum-based doublet chemotherapy. The objective was to evaluate the efficacy of the nintedanib/docetaxel combination in patients who also received immunotherapy. RESULTS: Eleven patients met the inclusion criteria; with a median age of 67 years. PD-L1 expression was positive in six patients. Median progression-free survival (PFS) of first-line platinum-based chemotherapy was 3.3 months (95% CI 1.9-4.6). Second-line immunotherapy was pembrolizumab (36.5%), atezolizumab (36.5%) or nivolumab (27%). Median PFS of second-line immunotherapy was 2.3 months (95% CI 0-6.1). The overall response rate (ORR) to second-line immunotherapy was 18% with a disease-control rate (DCR) of 45%. Median PFS of nintedanib/docetaxel was 3.2 months (95% CI 1.9-4.5). Best response was partial response in four patients (36%), stable disease in five patients (46%), and progressive disease in two patients (18%), for an ORR of 36% and a DCR of 82%. CONCLUSION: Our experience suggests an encouraging efficacy of nintedanib/docetaxel in patients with adenocarcinoma NSCLC pretreated with platinum-based doublet chemotherapy and immunotherapy, reinforcing the importance of an optimal therapeutic sequence for managing advanced lung adenocarcinoma.
Filiaciones:
Corral, J:
Clin Univ Navarra, Calle Marquesado Santa Marta 1, Madrid 28027, Spain
Majem, M:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Rodriguez-Abreu, D:
Hosp Univ Insular De Gran Canaria, Las Palmas Gran Canaria, Spain
Carcereny, E:
Hosp Badalona Germans Trias & Pujol, Catalan Inst Oncol, Barcelona, Spain
Cortes, A:
Hosp Univ Miguel Servet, Zaragoza, Spain
:
Hosp Gen Univ Elda, Alicante, Spain
Picazo, J:
Clin Univ Navarra, Pamplona, Spain
Garcia, Y:
Corporacio Sanitaria Parc Tauli, Barcelona, Spain
Domine, M:
Hosp Univ Fdn Jimenez Diaz, Madrid, Spain
Criado, M:
MD Anderson Canc Ctr, Madrid, Spain
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