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PROGNOSTIC ROLE OF FILGRASTIM IN THE EFFECTIVENESS OF PD-1/PD-L1 INHIBITORS IN PREVIOUSLY TREATED PATIENTS WITH NON-SMALL CELL LUNG CANCER

JUAN FRANCISCO MARIN POZO 1*, CARMEN LUCIA MUÑOZ CID 1, RAQUEL
CLARAMUNT GARCIA 2, ELVIRA MARIN CABA 3, ANA LAURA ORTEGA GRANADOS 4

1Hospital Pharmacy Department, Hospital Universitario de Jaén, Spain
2 Hospital Pharmacy Department, Hospital Virgen de Altagracia, Manzanares, Spain
3 Preventive Medicine and Epidemiology Department. Hospital Clínico San Cecilio, Granada, Spain
4 Medical Oncology Department, Hospital Universitario de Jaén, Spain

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The aim of this study was to determine whether the use of granulocyte-growth factors (G-CSF) during the first-line therapy of non-small-cell lung cancer (nSCLC) influences the effectiveness of anti-PD1/PD-L1 drugs (aPD1-i) used in subsequent therapies. We designed a single-centre, observational, retrospective study with nSCLC patients treated with aPD1-i (nivolumab, pembrolizumab, or atezolizumab) after primary platinum-based chemotherapy in southern Spain. The primary endpoints were overall survival (OS) and progression free survival (PFS). The results were assessed using the Kaplan-Meier method for GCSF-use. We enrolled 79 patients (91% male) with a mean age of 66.7 years. Nivolumab, atezolizumab, and pembrolizumab were used in 55.7%, 25.3% and 19.0% of the patients, respectively. G-CSF was administered to 19 patients. The median treatment duration was 4.1 months (95%CI: 2.3 - 5.8). Overall survival (OS) and progression free survival (PFS) were 7.3 (95%CI: 3.4 - 11.3) and 4.4 months (95%CI: 2.3 - 6.5), respectively. The median OS was 15.8 months (95%CI: 1.2-30.3) in G-CSF-treated patients and 5.3 months (95%CI: 2.3 - 8.3) in the non-treated group (p = 0.186). Higher OS was observed in all subgroups. The effectiveness of aPD1-i in previously treated nSCLC patients was higher in the G-CSF-treated group than in the non-treated group, although the difference not was statistically significant. These results may contribute to improving the effectiveness of anti-PD1/PD-L1 drugs, although confirmatory prospective studies are required.