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Poster display session

313P - Immunotherapy application for advanced cancers: One institution experiences since 2016 to 2019

Date

23 Nov 2019

Session

Poster display session

Topics

Tumour Site

Head and Neck Cancers

Presenters

Jo Pai Chen

Citation

Annals of Oncology (2019) 30 (suppl_9): ix97-ix106. 10.1093/annonc/mdz428

Authors

J.P. Chen

Author affiliations

  • Oncology, National Taiwan University Hospital - Yunlin Branch, 640 - Douliu City/TW

Resources

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Abstract 313P

Background

Immunotherapy has brought clinical benefits in several kinds of advanced cancers, including melanoma, renal cell carcinoma, non-small cell lung cancer, gastric cancer, HNSCC, esophageal cancer, hepatocellular carcinoma, and urinary tract cancers. Reliable biomarkers, best sequencing, and novel combinations for cancer immunotherapy warrant further investigation. Our group will present immunotherapy experiences for advanced cancers since 2016 to 2019 to show possible clinical impacts, choices of several combinations, toxicity profiles, favorable cancer types, and potential biomarkers exploratio.

Methods

Since Jan 2016 to Feb 2019, we reviewed the details of immunotherapy(anti-PD1or anti-PDL1 or anti-CTLA4 monoclonal antibody) application from cancer patients in Yin-lin Branch of National Taiwan University Hospital.

Results

Total 153 refractory cancer patients were collected due to previous or current use of immunotherapy. 69 patients received pembrolizumab(33 with triweekly 2 mg/kg & 36 with triweekly 200 mg); 74 received nivolumab(from 20 mg totally to 3 mg/kg biweekly); 2 ever received pembrolizumab and then nivolumab with ipilimumab; 1 ever received pembrolizumab and then pembrolizumab with ipilimumab; 5 received atezolizumab(2 NSCLC, 1 SCLC, 2 urinary tract cancers); 2 durvalumab (NSCLC). The cancer types were listed as following: 32 NSCLC(11 SCC, 19 adenocarcinoma, 1 adenosquamous, 1 pleomorphic); 2 SCLCs; 30 HNSCC(1 HPV, 29 non-HPV); 5 NPC; 15 esophageal cancers; 6 gastric cancers(1 with MSI-H); 2 high grade serous ovary cancer; 1 skin basal cell carcinoma; 1 thymic cancer; 36 HCC; 3 intra-hepatic cholangiocarcinoma; 2 malignant peripheral nerve sheath tumors; 8 urinary tract cancers; 1 RCC; 2 liver neuroendocrine tumors; 1 adrenal carcinoma; 1 breast cancer; 1 mesothelioma; 2 melanoma; 1 primary CNS lymphoma; 1 Papilla of Vater cancer(HER2 amplification and high TMB). The overall clinical benefits were 85%(130/153) and objective response rates were 43%(66/153).

Table: 313P

Cancer typesORRComments
Urinary tract cancers7/8(87.5%)With Avastin and chemotherapy
Esophageal cancer9/15(60%)Afatinib with anti-PD1
NSCLC19/32(59%)KN189/IMpower150 in Adeno; CM227 in SCC
HNSCC14/30(47%)Afatinib with anti-PD1(easy autoimmune cholestasis and interstitial pneumonitis with pembrolizumab)
HCC9/36(25%)With metronomic therapy, Avastin, or chemotherapy
SCLC1/2(50%)+/-Avastin
NPC2/5(40%)Biomarkers needed
GC1/6(17%)Responder in MSI-H
Papilla of Vater cancer1 stable diseaseHER2 amplification and high TMB
Skin cancer1/1High TMB
Cholangiocarcinoma0/3Combinations searching
RCC1/1With anti-angiogenesis Tx
PCNSL1/1Rituximab with nivolumab

Conclusions

In one institutional experiences, immunotherapy combinations for refractory advanced cancers have brought encouraging responses and clinical benefits, esp. in urinary tract cancer, esophageal cancers, NSCLC, HNSCC, HCC(the top 5 cancer types endemic in Yun-lin), NPC, skin cancers, primary CNS lymphoma, and cancers with MSI-H or high TMB. Individual combinations, biomarkers, sequencing, and toxicities may be explored in different kinds of advanced cancers to reach favorable outcomes.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

IRB in National Taiwan University Hospital.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.

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