Romanian Society of Pharmaceutical Sciences

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