None of the patients in a study with lung cancer and hepatic metastases experienced an objective response in their liver tumors after anti-PD1 therapy, according to research presented at ASCO’s Society for Immunotherapy of Cancer’s 2017 Clinical Immuno-Oncology Symposium (February 23-25, 2017; abstract 38).
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Immune checkpoint inhibitors – such as the human programmed death receptor-1 (PD-1) blocking antibody Nivolumab – have demonstrated efficacy in improving outcomes in advanced lung cancer as well as other malignancies. However, efficacy appears to vary based on the site of the disease. Limited research has explored nivolumab’s effects in various metastases.
Srikala Addepalli, MD, Brody School of Medicine, East Carolina University (NC), and colleagues conducted a retrospective review of data from 75 patients with lung cancer treated with nivolumab, 13% of whom (n = 9) had hepatic metastases. The patients were an average age of 61.8 years and were predominately male (66%). A total of 22% of the patients had squamous cell, 33% had adenocarcinoma, and 44% had small cell neuroendocrine histology. Patients received an average of 1.7 therapies (range, 1-4) prior to nivolumab. Each patient received an average of 4 cycles of nivolumab and 44% received adjunctive therapy, including ablative radiation or immune-modulating chemotherapy, with the aim of augmenting the effect of the anti-PD1 therapy.
Results of the analysis showed that none of the patients with hepatic metastases experienced an objective decrease in their liver metastases after nivolumab treatment. The average survival among these patients after initial nivolumab treatment was 132 days.
Researchers noted that their study was the largest reported series examining patients with hepatic metastases from lung cancer treated with PD-1 inhibitors. Regardless, their observations were consistent with prior research indicating poor outcomes with anti-PD1 therapy in patients with hepatic metastases.
Researchers conclude that “mechanisms underlying such resistance must be elucidated so that more effective treatment combinations can be developed.” – Zachary Bessette
