109P Treatment Patterns in Patients with Advanced Non-Small Cell Lung Cancer (ansclc) after Discontinuing an Immune Checkpoint Inhibitor (ICI) Therapy in Second-Line or Later in Germany and France

BackgroundAlthough ICIs have been widely used in aNSCLC, little is known about subsequent treatment (Tx) patterns after discontinuing ICIs in second-line or later (2L+). This analysis aimed to describe Tx patterns following ICI discontinuation in Germany and France.MethodsThis observational study was based on two data sources: CRISP [C], a prospective cohort from over 170 centres in Germany, and ESME-AMLC [E], a retrospective cohort compiling existing comprehensive data from 30 centres in France. Patients with aNSCLC who discontinued a 2L+ ICI in 2016–2019 at [C] and 2015–2018 at [E] were included. Tx regimens following ICI discontinuation due to progression or toxicity were described. Patients were followed until death, last visit, or end of the study period (June 2020 in [C]; August 2019 in [E]).ResultsTable: 109P2L+ ICI discontinuation due to:ProgressionToxicityCRISPESME-AMLCCRISPESME-AMLCN366109940144Received subsequent regimen, n (%)202 (55.2)802 (73.0)15 (37.5)63 (43.8)First regimen after ICIPlatinum (PT)-based chemo30 (8.2)116 (10.6)<511 (7.6)Docetaxel alone40 (10.9)202 (18.4)<56 (4.2)Clinical trials<514 (1.3)00EGFR/ALK TKI7 (1.9)54 (4.9)<5<5Nintedanib/ramucirumab-based regimens63 (17.2)0<50ICI Same ICI5 (1.4) <538 (3.5) 35 (3.2)<5 <524 (16.7) 20 (13.9)Other non-PT-based chemo54 (14.8)377 (34.3)7 (17.5)19 (13.2)Died (no subsequent Tx)135 (36.9)176 (16.0)21 (52.5)36 (25.0)Censored alive (no subsequent Tx at last follow-up)29 (7.9)121 (11.0)4 (10.0)45 (31.2) Open table in a new tab ConclusionsThese are the first results from a joint research initiative run with two large data sources in Germany and France. The majority of patients discontinuing 2L+ICI due to progression received a subsequent Tx, but only a small proportion (<5%) continued with an ICI or restarted an ICI after ≥1 other regimen. Patients discontinuing due to toxicity were more likely to be rechallenged with an ICI. Further follow-up and analyses will assess the impact of Tx patterns following 2L+ ICI discontinuation on survival outcomes in aNSCLC.Editorial acknowledgementProfessional writing and editorial assistance were provided by Adam Beech, PhD, of LATITUDE, funded by Bristol Myers Squibb.Legal entity responsible for the studyBristol Myers Squibb.FundingBristol Myers Squibb.DisclosureF. Griesinger: Financial Interests, Personal and Institutional, Invited Speaker: AstraZeneca; Financial Interests, Personal and Institutional, Writing Engagements: AstraZeneca; Financial Interests, Personal and Institutional, Speaker’s Bureau: AstraZeneca; Financial Interests, Personal and Institutional, Advisory Board: AstraZeneca; Financial Interests, Personal and Institutional, Research Grant: AstraZeneca; Financial Interests, Personal and Institutional, Funding: AstraZeneca; Financial Interests, Personal and Institutional, Invited Speaker: Boehringer-Ingelheim; Financial Interests, Personal and Institutional, Writing Engagements: Boehringer-Ingelheim; Financial Interests, Personal and Institutional, Speaker’s Bureau: Boehringer-Ingelheim; Financial Interests, Personal and Institutional, Advisory Board: Boehringer-Ingelheim; Financial Interests, Personal and Institutional, Research Grant: Boehringer-Ingelheim; Financial Interests, Personal and Institutional, Funding: Boehringer-Ingelheim; 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M. Pérol: Financial Interests, Institutional, Research Grant: Roche; Financial Interests, Institutional, Principal Investigator: Roche; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Other, Travel support: Roche; Financial Interests, Institutional, Principal Investigator: Lilly; Financial Interests, Personal, Invited Speaker: Lilly; Financial Interests, Personal, Advisory Board: Lilly; Financial Interests, Personal, Other, Travel support: Lilly; Financial Interests, Personal, Invited Speaker: Boehringer-Ingelheim; Financial Interests, Personal, Advisory Board: Boehringer-Ingelheim; Financial Interests, Personal, Other, Travel support: Boehringer-Ingelheim; Financial Interests, Institutional, Principal Investigator: Merck Sharp & Dohme; Financial Interests, Personal, Invited Speaker: Merck Sharp & Dohme; Financial Interests, Personal, Advisory Board: Merck Sharp & Dohme; Financial Interests, Institutional, Principal Investigator: Bristol Myers Squibb; Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb; Financial Interests, Institutional, Research Grant: AstraZeneca; Financial Interests, Institutional, Principal Investigator: AstraZeneca; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Other, Travel support: AstraZeneca; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Institutional, Principal Investigator: Takeda; Financial Interests, Personal, Invited Speaker: Takeda; Financial Interests, Personal, Advisory Board: Takeda; Financial Interests, Personal, Other, Travel support: Takeda; Financial Interests, Personal, Invited Speaker: Chugai; Financial Interests, Personal, Advisory Board: Gritstone; Financial Interests, Personal, Invited Speaker: Illumina; Financial Interests, Personal, Invited Speaker: Amgen; Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: Sanofi; Financial Interests, Personal, Advisory Board: GlaxoSmithKline; Financial Interests, Institutional, Principal Investigator: AbbVie; Financial Interests, Personal, Advisory Board: AbbVie; Financial Interests, Institutional, Principal Investigator: Daiichi Sankyo; Financial Interests, Personal, Principal Investigator: Apollomics; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Other, Travel support: Pfizer. I. Durand-Zaleski: Financial Interests, Personal, Invited Speaker: Abbott; Financial Interests, Personal, Advisory Board: Abbott; Financial Interests, Personal, Advisory Role: Abbott; Financial Interests, Personal, Invited Speaker: Air Liquide; Financial Interests, Personal, Advisory Board: Air Liquide; Financial Interests, Personal, Advisory Role: Air Liquide; Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb; Financial Interests, Personal, Advisory Role: Bristol Myers Squibb; Financial Interests, Personal, Invited Speaker: Boston Scientific; Financial Interests, Personal, Advisory Board: Boston Scientific; Financial Interests, Personal, Advisory Role: Boston Scientific; Financial Interests, Personal, Invited Speaker: Medtronic; Financial Interests, Personal, Advisory Board: Medtronic; Financial Interests, Personal, Advisory Role: Medtronic; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Role: MSD; Financial Interests, Personal, Invited Speaker: Sanofi; Financial Interests, Personal, Advisory Board: Sanofi; Financial Interests, Personal, Advisory Role: Sanofi; Financial Interests, Personal, Invited Speaker: Takeda; Financial Interests, Personal, Advisory Board: Takeda; Financial Interests, Personal, Advisory Role: Takeda. A. Calleja: Financial Interests, Personal and Institutional, Full or part-time Employment: IQVIA (contract research organisation). S. Patel: Financial Interests, Personal, Full or part-time Employment: IQVIA (contract research organisation). D. Waldenberger: Financial Interests, Personal, Full or part-time Employment: Bristol Myers Squibb. D. Reynaud: Financial Interests, Personal, Full or part-time Employment: Bristol Myers Squibb. R. Carroll: Financial Interests, Personal and Institutional, Full or part-time Employment: Bristol Myers Squibb; Financial Interests, Personal and Institutional, Stocks/Shares: Bristol Myers Squibb. M.J. Daumont: Financial Interests, Personal and Institutional, Full or part-time Employment: Bristol Myers Squibb; Financial Interests, Personal and Institutional, Stocks/Shares: Bristol Myers Squibb. J.R. Penrod: Financial Interests, Personal, Full or part-time Employment: Bristol Myers Squibb; Financial Interests, Personal, Stocks/Shares: Bristol Myers Squibb. L. Lacoin: Financial Interests, Personal, Full or part-time Employment: Epi-Fit; Financial Interests, Personal, Other, Consultant: Bristol Myers Squibb. C. Chouaid: Financial Interests, Personal, Other, Attending scientific meetings: AstraZeneca; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Other, Organising research: AstraZeneca; Financial Interests, Personal, Other, Consulting: AstraZeneca; Financial Interests, Personal, Other, Attending scientific meetings: Boehringer-Ingelheim; Financial Interests, Personal, Invited Speaker: Boehringer-Ingelheim; Financial Interests, Personal, Other, Organising research: Boehringer-Ingelheim; Financial Interests, Personal, Other, Consulting: Boehringer-Ingelheim; Financial Interests, Personal, Other, Attending scientific meetings: GlaxoSmithKline; Financial Interests, Personal, Invited Speaker: GlaxoSmithKline; Financial Interests, Personal, Other, Organising research: GlaxoSmithKline; Financial Interests, Personal, Other, Consulting: GlaxoSmithKline; Financial Interests, Personal, Other, Attending scientific meetings: Roche; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Other, Organising research: Roche; Financial Interests, Personal, Other, Consulting: Roche; Financial Interests, Personal, Other, Attending scientific meetings: Sanofi Aventis; Financial Interests, Personal, Invited Speaker: Sanofi Aventis; Financial Interests, Personal, Other, Organising research: Sanofi Aventis; Financial Interests, Personal, Other, Consulting: Sanofi Aventis; Financial Interests, Personal, Other, Attending scientific meetings: Bristol Myers Squibb; Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb; Financial Interests, Personal, Other, Organising research: Bristol Myers Squibb; Financial Interests, Personal, Other, Consulting: Bristol Myers Squibb; Financial Interests, Personal, Other, Attending scientific meetings: MSD; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Personal, Other, Organising research: MSD; Financial Interests, Personal, Other, Consulting: MSD; Financial Interests, Personal, Other, Attending scientific meetings: Lilly; Financial Interests, Personal, Invited Speaker: Lilly; Financial Interests, Personal, Other, Organising research: Lilly; Financial Interests, Personal, Other, Consulting: Lilly; Financial Interests, Personal, Other, Attending scientific meetings: Novartis; Financial Interests, Personal, Invited Speaker: Novartis; Financial Interests, Personal, Other, Organising research: Novartis; Financial Interests, Personal, Other, Consulting: Novartis; Financial Interests, Personal, Other, Attending scientific meetings: Pfizer; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Other, Organising research: Pfizer; Financial Interests, Personal, Other, Consulting: Pfizer; Financial Interests, Personal, Other, Attending scientific meetings: Takeda; Financial Interests, Personal, Invited Speaker: Takeda; Financial Interests, Personal, Other, Organising research: Takeda; Financial Interests, Personal, Other, Consulting: Takeda; Financial Interests, Personal, Other, Attending scientific meetings: Bayer; Financial Interests, Personal, Invited Speaker: Bayer; Financial Interests, Personal, Other, Organising research: Bayer; Financial Interests, Personal, Other, Consulting: Bayer; Financial Interests, Personal, Other, Attending scientific meetings: Janssen; Financial Interests, Personal, Invited Speaker: Janssen; Financial Interests, Personal, Other, Organising research: Janssen; Financial Interests, Personal, Other, Consulting: Janssen; Financial Interests, Personal, Other, Attending scientific meetings: Amgen; Financial Interests, Personal, Invited Speaker: Amgen; Financial Interests, Personal, Other, Organising research: Amgen; Financial Interests, Personal, Other, Consulting: Amgen. All other authors have declared no conflicts of interest. BackgroundAlthough ICIs have been widely used in aNSCLC, little is known about subsequent treatment (Tx) patterns after discontinuing ICIs in second-line or later (2L+). This analysis aimed to describe Tx patterns following ICI discontinuation in Germany and France. Although ICIs have been widely used in aNSCLC, little is known about subsequent treatment (Tx) patterns after discontinuing ICIs in second-line or later (2L+). This analysis aimed to describe Tx patterns following ICI discontinuation in Germany and France. MethodsThis observational study was based on two data sources: CRISP [C], a prospective cohort from over 170 centres in Germany, and ESME-AMLC [E], a retrospective cohort compiling existing comprehensive data from 30 centres in France. Patients with aNSCLC who discontinued a 2L+ ICI in 2016–2019 at [C] and 2015–2018 at [E] were included. Tx regimens following ICI discontinuation due to progression or toxicity were described. Patients were followed until death, last visit, or end of the study period (June 2020 in [C]; August 2019 in [E]). This observational study was based on two data sources: CRISP [C], a prospective cohort from over 170 centres in Germany, and ESME-AMLC [E], a retrospective cohort compiling existing comprehensive data from 30 centres in France. Patients with aNSCLC who discontinued a 2L+ ICI in 2016–2019 at [C] and 2015–2018 at [E] were included. Tx regimens following ICI discontinuation due to progression or toxicity were described. Patients were followed until death, last visit, or end of the study period (June 2020 in [C]; August 2019 in [E]). ResultsTable: 109P2L+ ICI discontinuation due to:ProgressionToxicityCRISPESME-AMLCCRISPESME-AMLCN366109940144Received subsequent regimen, n (%)202 (55.2)802 (73.0)15 (37.5)63 (43.8)First regimen after ICIPlatinum (PT)-based chemo30 (8.2)116 (10.6)<511 (7.6)Docetaxel alone40 (10.9)202 (18.4)<56 (4.2)Clinical trials<514 (1.3)00EGFR/ALK TKI7 (1.9)54 (4.9)<5<5Nintedanib/ramucirumab-based regimens63 (17.2)0<50ICI Same ICI5 (1.4) <538 (3.5) 35 (3.2)<5 <524 (16.7) 20 (13.9)Other non-PT-based chemo54 (14.8)377 (34.3)7 (17.5)19 (13.2)Died (no subsequent Tx)135 (36.9)176 (16.0)21 (52.5)36 (25.0)Censored alive (no subsequent Tx at last follow-up)29 (7.9)121 (11.0)4 (10.0)45 (31.2) Open table in a new tab ConclusionsThese are the first results from a joint research initiative run with two large data sources in Germany and France. The majority of patients discontinuing 2L+ICI due to progression received a subsequent Tx, but only a small proportion (<5%) continued with an ICI or restarted an ICI after ≥1 other regimen. Patients discontinuing due to toxicity were more likely to be rechallenged with an ICI. Further follow-up and analyses will assess the impact of Tx patterns following 2L+ ICI discontinuation on survival outcomes in aNSCLC. These are the first results from a joint research initiative run with two large data sources in Germany and France. The majority of patients discontinuing 2L+ICI due to progression received a subsequent Tx, but only a small proportion (<5%) continued with an ICI or restarted an ICI after ≥1 other regimen. Patients discontinuing due to toxicity were more likely to be rechallenged with an ICI. Further follow-up and analyses will assess the impact of Tx patterns following 2L+ ICI discontinuation on survival outcomes in aNSCLC.