5PSQ-010 Pembrolizumab in metastatic non-small-cell lung cancer and poor prognostic factors in clinical practice

<h3>Background and Importance</h3> Pembrolizumab is indicated for metastatic non-small-cell lung cancer (mNSCLC), both squamous histology and adenocarcinoma with chemotherapy or as monotherapy in case of PD-L1 expression ≥ 50%. Attempts are being made to decipher which variables can serve as a prognosis for patients undergoing immunotherapy.¹ <h3>Aim and Objectives</h3> To evaluate the association between potential prognostic factors and median overall survival (mOS) and progression-free survival (mPFS). <h3>Material and Methods</h3> Observational, retrospective and descriptive study of the efficacy and poor prognostic factors of pembrolizumab in mNSCLC, in a tertiary care hospital from June 2020 to September 2024. The variables collected were: sex, age, type of mNSCLC (adenocarcinoma, squamous, non-specific (NOS)), type of treatment (pembrolizumab monotherapy or chemotherapy), start and end date of pembrolizumab, death. The variables included considered as risk factors were: high lactate dehydrogenase values, central nervous system metastasis, neutrophil-lymphocyte ratio &gt;4, and Eastern Cooperative Oncology Group performance status &gt;2. Data were collected from the medical records. The total mOS and mPFS were calculated, as well as those of the different subgroups. The SPSS program was used for data analysis. <h3>Results</h3> A total of 69 patients were studied, the median age was 65 (29–82) years, 73.1% of whom were men. Regarding the subtypes of mNSCLC: 11.59% were NOS, 55.07% adenocarcinoma, and 33.34% squamous. 31.9% of patients received pembrolizumab as monotherapy, the rest with chemotherapy according to histology. The subgroups created were three according to the number of risk factors: low (0), intermediate (1) and high (≥2). The number of patients belonging to them respectively was: 21, 30 and 18. The results are shown in table 1. For the subgroup analysis of mPFS, in Log-Rank test p-value was 0.004 and for analysis of mOS p-value was &lt;0.001. <h3>Conclusion and Relevance</h3> A significant difference was observed in both mOS and mPFS according to risk subgroups. But it is necessary to take into account the small size of the sample, so more research is needed. <h3>References and/or Acknowledgements</h3> https://pubmed.ncbi.nlm.nih.gov/37577328/ <h3>Conflict of Interest</h3> No conflict of interest