Real-world patients with BRAF-, HER2-, MET– or RET-altered non-small cell lung cancer (NSCLC) appeared to clinically benefit from immune checkpoint blockade, according to the results of a retrospective, multicenter study published in the Journal of Thoracic Oncology.

The study included 107 patients across 21 French Lung Cancer Group centers. Patients had a mean age of diagnosis of 65.5 years (standard deviation, 10.3 years) and approximately half of participants (54%) were men. Overall, 37% of patients were never-smokers, and patients received a median of 1 prior line of therapy (range, 0–5 lines). Most patients were treated with either nivolumab (80%) or pembrolizumab (17%).  

A total of 44 patients (41%) had a BRAF mutation, of whom 26 had a V600 mutation and 18 had a non-V600 mutation; 30 (34%) had a MET mutation; 23 (22%) had a HER2 mutation; 9 (11%) had a RET translocation; and 1 (1%) had a MET amplification.

For the study cohort, the median duration of response was 15.4 months (95% CI, 12.6–not reached [NR]), the progression-free survival (PFS) was 4.7 months (95% CI, 2.3–7.4), and the overall survival (OS) was 16.2 months (95% CI, 12.0–24.0). The response rates were similar for the NSCLC molecular aberrations evaluated in the study: 26% for BRAF-V600, 33% for BRAF-nonV600, 27% for HER2, 38% for MET, and 38% for RET.

Among the 45 patients for whom PD-L1 status was known, the PFS was 3.0 months (95% CI, 1.2–NR) for PD-L1–negative patients and 4.3 months (95% CI, 2.1–8.5) for PD-L1–positive patients, and the OS was 13.3 months (95% CI, 4.1–NR) for PD-L1–negative patients and 35.2 months (95% CI, 9.0–35.2) for PD-L1–positive patients.

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Overall, 26% of patients had an adverse event, and 10% had a grade 3 or higher immune-mediated adverse event.

“In this real-world setting analysis, ICI efficacy in patients with BRAF-, MET– and HER2-mutated or RET-translocated NSCLC appeared close to that observed in patients with pretreated unselected NSCLC in randomized controlled trials or observational studies,” the study authors concluded.

Disclosure: Some of the authors disclosed financial relationships with pharmaceutical and medical device companies. For a full list of disclosures, please refer to the original study.

Reference

Guisier F, Dubos-Arvis C, Viñas F, et al. Efficacy and safety of anti-PD-1 immunotherapy in patients with advanced non small cell lung cancer with BRAF, HER2 or MET mutation or RET-translocation. GFPC 01-2018. J Thorac Oncol. doi: 10.1016/j.jtho.2019.12.129