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Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

3743 - Association of efficacy and immune-related adverse events (irAEs) in patients with NSCLC receiving immune-checkpoint inhibitors (ICIs)

Date

20 Oct 2018

Session

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

Topics

Immunotherapy;  Supportive Care and Symptom Management

Tumour Site

Presenters

Marion Riudavets Melia

Citation

Annals of Oncology (2018) 29 (suppl_8): viii493-viii547. 10.1093/annonc/mdy292

Authors

M. Riudavets Melia1, I. Gabriela Sullivan1, A. Barba Joaquín1, G. Anguera Palacios1, L.P. del Carpio1, C. Molto Valiente1, S.D. Camacho Arellano1, S. Moron Asensio1, P. Gomila Pons1, M. Andres Granyó1, D. Castillo Villegas2, C. Facundo Molas3, E. Garcia Planella4, C. González Blanco5, A. Barnadas Molins1, I. Gich Saladich6, M. Majem Tarruella1

Author affiliations

  • 1 Medical Oncology, Hospital de la Santa Creu i Sant Pau, 8026 - Barcelona/ES
  • 2 Pneumology, Hospital de la Santa Creu i Sant Pau, 8026 - Barcelona/ES
  • 3 Nephrology, Puigvert Foundation, 8025 - Barcelona/ES
  • 4 Gastroenterology, Hospital de la Santa Creu i Sant Pau, 8026 - Barcelona/ES
  • 5 Endocrinology, Hospital de la Santa Creu i Sant Pau, 8026 - Barcelona/ES
  • 6 Epidemiology, Hospital de la Santa Creu i Sant Pau, 8026 - Barcelona/ES
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Resources

Abstract 3743

Background

ICIs are a standard treatment in advanced NSCLC. However, ICIs can induce irAEs that may interrupt treatment. Here we report the incidence of irAEs and its correlation with efficacy.

Methods

We retrospectively analyzed 101 patients (pts) with advanced NSCLC receiving ICIs in our institution from March 2014 to January 2018. IrAEs were graded following CTCAE v4.0. Kaplan Meier and log-rank tests were used to evaluate progression-free (PFS) and overall survival (OS). Analyses were performed using SPSS v24 package.

Results

Median age was 66.4 [37-85] years, 74.3% were male. 33 (32.7%) pts presented squamous and 68 (67.3%) non-squamous histology. Most frequent ICIs were nivolumab (50%), pembrolizumab (31%) and atezolizumab (16%), used as monotherapy (79.2%) or in combination with chemotherapy (20.8%). Median duration of treatment was 2.7 [0.6-26.2] months. 61 (60.4%) pts developed 106 irAEs, with a mean of 1.02 [0-4] irAEs/pts. Most frequent irAEs were rash (24.5%), pruritus (22.6%), diarrhea (21%), thyroid dysfuncion (10.5%), arthritis (8.5%), hepatitis (2.9%) and pneumonitis (2%). 8 (7.5%) patients experienced grade (G) 3-4 irAEs: 1 G3 pneumonitis, 4 G3 diarrhea, 1 G3 mucositis, 1 G3 nephritis and 1 G3 haemolytic anemia. There was one treatment-related death due to pneumonitis. 47 (46.5%) pts received systemic corticosteroids during immunotherapy, 29.8% for irAEs management. 11 (10.9%) pts discontinued treatment due to irAEs. At the time of data analysis, 86.8% of irAEs had improved. With a median follow-up of 8.9 [0.6-48.2] months, median OS was superior in pts experiencing irAEs: not reached (NR) vs 7.8 [95%CI, 5.2-10.5] months (p 0.001). Similarly, PFS was significantly longer: 6.2 [95%CI, 2.3-10.1] vs 2.7 [95%CI, 1.8-3.5] months (p < 0.0001). OS was higher in pts who didn't receive steroids during ICIs: NR vs 9.9 [95%CI, 6.8-13.0] months (p 0.024). No association was found between efficacy and the use of antibiotics in the 3 months before first ICIs injection or during treatment.

Conclusions

Development of irAEs was associated with efficacy of ICIs in pts with advanced NSCLC. A negative correlation between the use of systemic corticosteroids and outcomes was found.

Clinical trial identification

Legal entity responsible for the study

Medical Oncology Department, Hospital de la Santa Creu i Sant Pau.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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