Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display - Cocktail

1051 - Real World Experience of adverse events with immunotherapy using PD1 inhibitors- Single center experience from India

Date

24 Nov 2018

Session

Poster display - Cocktail

Presenters

Amit Rauthan

Citation

Annals of Oncology (2018) 29 (suppl_9): ix23-ix27. 10.1093/annonc/mdy430

Authors

A. Rauthan1, P. Patil2, S.P. Somashekhar3, S. Zaveri3

Author affiliations

  • 1 Department Of Medical Oncology, Manipal Comprehensive Cancer Center Manipal Hospital, 560017 - Bangalore/IN
  • 2 Medical Oncology, Manipal Comprehensive Cancer Center Manipal Hospital, 560017 - Bangalore/IN
  • 3 Surgical Oncology, Manipal Comprehensive Cancer Center Manipal Hospital, 560017 - Bangalore/IN
More

Resources

Abstract 1051

Background

Immunotherapy with PD1/PDL1 checkpoint inhibitors has made a dramatic change in the treatment of many cancers like melanoma, Renal cell cancer (RCC), lung cancer and head and neck cancer. Understanding the toxicity profile of immunotherapy is important, as they are different from chemotherapy and oral tyrosine kinase inhibitor side effects. Being new therapies, there is not much data about these immune related adverse events (irAEs) in Indian patients.

Methods

We retrospectively reviewed all patients who received treatment with PD1 inhibitors in our tertiary hospital from June 2016 to March 2018. The objective was to assess the various adverse events.

Results

70 patients received treatment with immunotherapy- 65 received Nivolumab and 5 Pembrolizumab. The 70 patients were as follows - 20 lung cancers, 20 RCC, 10 melanomas, 8 head and neck cancers, 3 urinary bladder cancers, 2 MMR deficient colon cancers, 2 stomach cancers, 2 breast cancers, 2 sarcomas and 1 ovarian cancer. Patient age ranged from 31 to 87 years. Number of cycles ranged from 2 to 18 cycles. Thyroid abnormality were the most common side effect, and was seen in 19 patients (27%). 15 patients (21.4%) had hypothyroidism, 2 (2.8%) had hyperthyroidism, and 2 (2.8%) had hyperthyroidism followed by hypothyroidism. Hypothyroidism was managed with thyroid replacement. Grade 2 skin toxicity in the form of pruritis and rash was seen in 6 patients (8.5%), and was managed with topical steroids. Grade 2 diarrhoea was seen in 5 patients (7.1%). Grade 1 elevation in liver enzymes was seen in 4 patients (5.7%). Pneumonitis was seen in 2 patients (2.8%). This was grade 3, requiring treatment with steroids and permanent discontinuation of immunotherapy. Grade 2 Arthritis was seen in 1 patient (1.4%), requiring temporary interruption, and treatment with oral steroids, with good resolution.

Conclusions

Treatment with PD1 checkpoint inhibitors is very well tolerated. The most common adverse events in our patients were hypothyroidism, skin rash and diarrhoea. Very few patients had grade 3 toxicity and there was no treatment related death. Though very well tolerated, we would need to be vigilant and aware of these unique side effects, to enable early pickup and early treatment with steroids.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Amit Rauthan.

Funding

Has not received any funding.

Disclosure

A. Rauthan: Advisory board: Roche, Merck, Bayer, Pfizer. All other authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings