Real-World Efficacy of Docetaxel Plus Nintedanib After Chemo-Immunotherapy Failure in Advanced Pulmonary Adenocarcinoma

Figures & data

Table 1. Patient characteristics.

Characteristic	n (%)
Sex:
– Female	34 (36.6)
– Male	59 (63.4)
Age (years), median (range)	61 (44–84)
ECOG:
– 0	43 (46.2)
– 1	43 (46.2)
– 2	7 (7.5)
Smoking status:
– Smoker	65 (69.9)
– Never-smoker	17 (18.3)
– Unknown/missing	11 (11.8)
PD-L1:
– 0%	46 (49.5)
– 1–49%	15 (16.1)
– ≥50%	11 (11.8)
– Unknown/missing	21 (22.6)
Mutation status:
– No identified driver mutation	53 (57.0)
– KRAS	21 (22.6)
– p53	11 (11.8)
– EGFR	3 (3.2)
– HER2	3 (3.2)
– CTNNB1	1 (1.1)
– MET	1 (1.1)
– ALK	0 (0.0)
– BRAF	0 (0.0)
Position of docetaxel + nintedanib in therapy sequence:
– 3L after 2L ICI	57 (61.3)
– 4L or above	19 (20.4)
– 2L after combination chemotherapy-ICI	10 (10.8)
– 3L after 1L pembrolizumab monotherapy	6 (6.5)
– 2L after pembrolizumab monotherapy	1 (1.1)
Prior ICI^†:
– Nivolumab	52 (55.9)
– Pembrolizumab	26 (28.0)
– Atezolizumab	12 (12.9)
– Durvalumab	2 (2.2)
– Nivolumab + atezolizumab	1 (1.1)
First-line therapy^‡:
– Cisplatin + pemetrexed	32 (34.4)
– Cisplatin + paclitaxel	19 (20.4)
– Cisplatin + vinorelbine	13 (14.0)
– Cisplatin + pemetrexed + pembrolizumab	8 (8.6)
– Carboplatin + pemetrexed	7 (7.5)
– Pembrolizumab	7 (7.5)
– Carboplatin + paclitaxel + bevacizumab	6 (6.5)
– Carboplatin + paclitaxel	5 (5.4)
– Cisplatin	2 (2.2)
– Afatinib	1 (1.1)
– Carboplatin + gemcitabine	1 (1.1)
– Carboplatin + gemcitabine + bevacizumab	1 (1.1)
– Carboplatin + nab-paclitaxel + bevacizumab	1 (1.1)
– Carboplatin + paclitaxel + pembrolizumab	1 (1.1)
– Carboplatin + pemetrexed + pembrolizumab	1 (1.1)
– Cisplatin + etoposide	1 (1.1)
– Erlotinib	1 (1.1)

Table illustrates the breakdown of relevant patient characteristics for all patients included in this retrospective analysis (n = 93).

† Prior therapy includes the described immunotherapy or chemotherapy treatment in any line before treatment with docetaxel plus nintedanib.

‡ Sum of first-line treatments is greater than 93 as 14 patients received two chemotherapy regimens as first-line treatment.

ECOG PS: Eastern Cooperative Oncology Group performance status; ICI: Immune checkpoint inhibitor; L: line.

Table 2. Efficacy of docetaxel plus nintedanib post-immune checkpoint inhibitor.

	All patients (n = 87)^†	Second line (n = 10)^‡	Third line (n = 52)^§	Third line after ICI/platinum subgroup (n = 6)^¶	≥Fourth line (n = 19)^#
Complete response, n (%)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)
Partial response, n (%)	36 (41.4)	4 (40.0)	26 (50.0)	0 (0.0)	6 (31.6)
Stable disease, n (%)	30 (34.5)	1 (10.0)	17 (32.7)	5 (83.3)	7 (36.8)
Progressive disease, n (%)	21 (24.1)	5 (50.0)	9 (17.3)	1 (16.7)	6 (31.6)
Overall response rate, n (%)	36 (41.4)	4 (40.0)	26 (50.0)	0 (0.0)	6 (31.6)
Disease control rate, n (%)	66 (75.9)	5 (50.0)	43 (82.7)	5 (83.3)	13 (68.4)

Table shows the reported efficacy outcomes assessed for docetaxel plus nintedanib for all patients included in the retrospective analysis and for each individual subgroup, stratified by number and type of previous treatment lines.

† 93 patients received treatment. Best response in all patients given docetaxel plus nintedanib across all lines is reported, calculated from evaluable patients (n = 87). Patients who discontinued therapy (n = 6) were excluded from analyses.

‡ 11 patients received second-line docetaxel plus nintedanib following first-line pembrolizumab plus chemotherapy. One patient who discontinued therapy was excluded from this analysis.

§ 57 patients received third-line docetaxel plus nintedanib; best response was calculated from evaluable patients (n = 52). Patients who discontinued therapy (n = 5) were excluded from this analysis. One additional patient, who received third-line docetaxel plus nintedanib after pembrolizumab monotherapy, was excluded from this group.

¶ A subgroup of six patients were given docetaxel plus nintedanib following first-line ICI and second-line platinum-doublet chemotherapy.

# 19 patients received fourth-line or later docetaxel plus nintedanib. Maximum eighth line identified and reported.

ICI: Immune checkpoint inhibitor.

Figure 1. Third-line treatment outcomes.

Kaplan-Meier curves illustrating the third-line treatment outcomes with docetaxel plus nintedanib following first-line chemotherapy and second-line immune checkpoint inhibitors, representing (A) treatment duration with docetaxel plus nintedanib (n = 57), (B) maintenance treatment with nintedanib (n = 20) and (C) overall survival following third-line docetaxel plus nintedanib treatment (n = 57).

Figure 2. Swimmer plot of patients who received third-line docetaxel plus nintedanib.

Data presented for 57 patients who received third-line docetaxel plus nintedanib. Treatment duration for first-line therapy was not available for 23 patients. Treatment duration for second-line therapy was not available for 33 patients.

DC: Discontinuation; ICI: Immune checkpoint inhibitor; PD: Progressive disease; PR: Partial response; SD: Stable disease.

Figure 3. Outcomes with docetaxel plus nintedanib across all treatment lines (n = 93).

Kaplan-Meier curves illustrating the overall treatment outcomes with docetaxel plus nintedanib across all treatment lines included in the analysis, representing (A) duration of treatment with docetaxel plus nintedanib (n = 93), (B) maintenance treatment with nintedanib (n = 23) and (C) overall survival following treatment with docetaxel plus nintedanib (n = 93).