A Multi-Center Real-World Experience of IMpower150 in Oncogene Driven Tumors and CNS Metastases

Area of Science:

• Oncology
• Medical Oncology
• Clinical Research

Background:

• Limited real-world data exists for the IMpower150 regimen in oncogene-driven tumors with central nervous system (CNS) metastases.
• This study addresses the need for data on IMpower150's efficacy and safety in a real-world setting.

Purpose of the Study:

• To evaluate the real-world effectiveness and safety of the IMpower150 regimen in patients with advanced non-small cell lung cancer (NSCLC).
• To specifically assess outcomes in patients with oncogene-driven tumors and central nervous system metastases.

Main Methods:

• Retrospective analysis of 106 patients with advanced NSCLC treated with IMpower150 across 12 Australian sites (July 2018 - April 2021).
• Correlation of clinicopathologic and treatment parameters with efficacy (overall response rate, survival) and toxicity.
• Analysis included patients with brain metastases, leptomeningeal disease (LMD), liver metastases, and EGFR mutations.

Main Results:

• The overall response rate was 51%, with 52% in EGFR-mutated patients. Median overall survival was 11.4 months.
• Patients with untreated brain metastases showed similar intracranial response rates (55%) as those with treated metastases (53%).
• Survival outcomes were notable for liver metastases (11.0 months) and brain metastases (11.4 months); LMD survival was 7.1 months. No new safety concerns were identified.

Conclusions:

• The IMpower150 regimen demonstrated clinically meaningful responses in a real-world, largely pre-treated, oncogene-positive NSCLC population.
• The regimen showed efficacy even in patients with central nervous system disease, including brain metastases and leptomeningeal disease.
• These findings support the use of IMpower150 in advanced NSCLC patients, particularly those with oncogene alterations and CNS involvement.