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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

3666 - Immune-related adverse events: comparison of melanoma and non-small cell lung cancer patients treated with anti-PD1 therapy.

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

Supportive Care and Symptom Management

Tumour Site

Melanoma

Presenters

Narjust Duma

Citation

Annals of Oncology (2018) 29 (suppl_8): viii400-viii441. 10.1093/annonc/mdy288

Authors

N. Duma1, A. Azzouqa2, S. Yadav1, K. Hoversten3, C. Reed3, A.N. Sitek3, Y. Lou2, J. Molina1, T. Halfdanarson1, K. Leventakos1, R.W. Joseph2, R. Manochakian2, R. Dronca2

Author affiliations

  • 1 Medical Oncology, Mayo Clinic, 55905 - Rochester/US
  • 2 Medical Oncology, Mayo Clinic, 32224 - Jacksonville/US
  • 3 Internal Medicine, Mayo Clinic, 55905 - Rochester/US
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Resources

Abstract 3666

Background

Immune-related adverse events (IRAEs) represent a clinical challenge, potentially limiting the clinical benefits of immunotherapy. Data suggests nivolumab and pembrolizumab IRAEs rates are similar but no comparisons across tumor types exist. Therefore, we studied IRAEs in patients (pts) with metastatic melanoma and non-small cell lung cancer (NSCLC) treated with anti-PD1 therapy.

Methods

All pts with metastatic melanoma and NSCLC seen at the Mayo Clinic Rochester and Florida from 2015 to 2018 were reviewed. Patients that received prior immunotherapies or thoracic radiation were excluded. Chi-square test was used to estimate differences in categorical data.

Results

Out of 510 pts, 266 (52%) had melanoma and 244 (48%) NSCLC. Baseline characteristics were similar across groups, except for sex (NSCLC: 51% women; melanoma: 40% women). 80% of the pts with NSCLC received chemotherapy prior to immunotherapy compared to 14% of the pts with melanoma. 75% (200) of melanoma pts received pembrolizumab and 66% (161) of NSCLC pts received nivolumab. Higher rates of IRAEs were observed in the melanoma pts (55% vs. 41%, <0.001) (Table). No difference in grade ≥3 IRAEs was observed. Melanoma pts were more likely to develop diarrhea/colitis and endocrinopathies compared to the NSCLC pts (19% vs. 7%, p < 0.008; 33% vs. 18%, p < 0.01, respectively). Contrarily, pts with NSCLC had higher rates of pneumonitis (14% vs. 6%, p < 0.007). Most pts resumed the anti-PD1 agent after developing IRAEs (60% and 57%, respectively). In 31% of the pts experiencing IRAEs the anti-PD1 agent was permanently discontinue due to toxicity.Table: 1218P

Melanoma % (n)NSCLC % (n)p value
IRAEs55 (146)41 (99)<0.001
Grade ≥2 IRAEs76 (110)75 (76)0.98
Grade ≥3 IRAEs34 (49)36 (36)0.68
Prescribed systemic steroids66 (97)60 (59)0.26
Required intravenous steroids25 (37)27 (27)0.75
IRAEs: Subtype (all grades)
Diarrhea/Colitis19 (28)7 (7)0.008
Dermatologic Toxicities19 (28)22 (22)0.62
Endocrinopathies33 (48)18 (18)0.01
Pneumonitis6 (8)14 (14)0.007
Transaminitis14 (21)9 (9)0.24
Immunotherapy was restarted60 (88)57 (56)0.60
Immunotherapy DC due to toxicity31 (45)31 (31)0.99

Conclusions

Patients with metastatic melanoma were more likely to develop IRAEs with anti-PD1 therapy. We observed differences in the IRAEs developed across groups. These associations could be attributed to intrinsic tumor characteristics or differences between anti-PD1 agents. Larger studies are needed to enhance our understanding of these differences.

Clinical trial identification

Legal entity responsible for the study

N. Duma.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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