Anti PD-(L)1 in KRAS mutant advanced nsclcs: A meta-analysis of randomized controlled trials.

Authors

null

Thierry Landre

UCOG-HUPSSD-APHP, Paris, France

Thierry Landre , Gregoire Justeau , Jean-baptiste Assié , Kader Chouahnia , Chérifa Taleb , Christos Chouaid , Boris Duchemann

Organizations

UCOG-HUPSSD-APHP, Paris, France, CHU D'Angers, Angers Cedex 9, France, Centre Hospitalier Intercommunal (CHI) Creteil, Créteil, France, Assistance Publique-Hopitaux de Paris, Bobigny, France, Geriatric Oncology, Hôpital René Muret, APHP, Sevran, France, Pneumology, Centre Hospitalier Intercommunal (CHI) Creteil, Créteil, France, APHP-Hopital Avicenne, Bobigny, France

Research Funding

No funding received
None

Background: KRAS comprise the most frequently found oncogene driver mutation in non-small cell lung cancer (NSCLC), accounting for 20-25% of these patients. Single-agent Anti PD-(L)1 clinical efficacy against KRAS mutant NSCLC is a topic of debate. Methods: This meta-analysis examined randomized-trial data comparing first-or second line Anti PD-(L)1 +/- chemotherapy (CT) vs CT alone for KRAS mutant advanced NSCLCs. Outcome measures included overall survival (OS) and progression-free survival (PFS). Analyses were computed using the Cochrane method of collaboration for meta-analyses, with Review Manager software (RevMan version 5.3; Oxford, UK). Results: We analyzed 3 trials in first line (IMPOWER-150, KEYNOTE-189 and KEYNOTE-042), as well as 3 trials in second line (OAK, POPLAR and CHECKMATE-057) including 1313 NSCLCs (386 KRAS mutant and 927 KRAS wild-type tumor). Anti PD-(L)1 +/- CT was significantly associated (hazard ratio [95% confidence interval]) with prolonged OS (0.59 [0.49-0.72]; p < 0.00001) and PFS (0.58 [0.43-0.78]; p = 0.0003) compared to CT alone in KRAS mutant NSCLCs. Survival benefits occured in both first and second line. Survival benefits observed in KRAS wild-type NSCLCs were (0.87 [0.76-0.99]; p = 0.03) and (0.79 [0.56-1.11]; p = 0.17) respectively. OS benefit in KRAS mutant was significantly superior compared to OS benefit in KRAS wild-type (p = 0,001). Conclusions: Anti PD-(L)1 (+/- CT) appears superior to CT alone both for mutant and wild-type KRAS in advanced NSCLCs for OS and PFS with higher magnitude of benefit in KRAS mutated group for OS.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Biologic Correlates

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 9025)

DOI

10.1200/JCO.2021.39.15_suppl.9025

Abstract #

9025

Poster Bd #

Online Only

Abstract Disclosures

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