Abstract 328P
Background
The presence of the immune-related adverse events (irAEs) has been reported as a preferred marker of the efficacy of immune checkpoint inhibitors (ICIs) in non-small cell lung cancer (NSCLC) patients. However, there are only a few studies that focused on the relationship between the efficacy of ICIs and the severity or a high-resolution computed tomography (HRCT) scan pattern of drug-induced lung disorder (DILD).
Methods
We conducted a retrospective study of patients with NSCLC who were treated with ICIs between January 2016 and June 2019 in our institution. We especially focused on the patients who developed DILD during ICIs treatment, and analyzed the clinical information and HRCT pattern of DILD to investigate the prognosis of patients who developed DILD. Assessment of treatment response was evaluated using the response evaluation criteria in solid tumors version 1.1. Severity of DILD was classified by grade according to pneumonitis in Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
Results
Total 182 patients were enrolled, including 20 patients who received chemotherapy with ICIs. Among the 182 patients, 32 patients (17.6 %) developed DILD and CTCAE grade 1/2/3/4/5 were 10/7/9/2/4 patients, respectively. The median progression-free survival was 100 and 93 days, (P = 0.324, Log-rank Test) and overall survival was 415 and 501 days (P = 0.0951, Log-rank Test) in patients with or without DILD, respectively. The median period from the first ICI treatment to onset of DILD was significantly shorter in the Grade 3/4/5 group than Grade 1/2 group; 22 and 72.5 days, respectively (P = 0.029, Mann-Whitney U test). Analyzing HRCT findings according to ATS/ERS/JRS/ALAT GUIDLINE, patients who presented consolidation had better prognosis than those with comprehensive GGO. In 4 patients with Grade 5 pneumonitis developed with comprehensive GGO and the period from onset of DILD to death was extremely short; median 2 days.
Conclusions
Our retrospective study suggested that development of DILD was not preferred in terms of prognosis in NSCLC patients. Physician should be alerted for the patients who developed early-onset, severe DILD with comprehensive GGO during ICI treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Hiroyuki Yamaguchi.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
329P - High-level expression of HDAC10 is associated with PD-L1 expression and poor prognosis in patients with non-small cell lung cancer receiving pulmonectomy
Presenter: Xiaomei Liu
Session: Poster display session
Resources:
Abstract
331P - A retrospective analysis of immune checkpoint therapy in patients with non-small cell lung cancer: Focus on thyroid disorder
Presenter: Sawana Ono
Session: Poster display session
Resources:
Abstract
332P - Analyse the association between adverse events (AEs) and survival in patients treated with immune checkpoint inhibitors (ICIs)
Presenter: Chi-yuan Cheng
Session: Poster display session
Resources:
Abstract
333P - Study of searching on efficacy of immune checkpoint inhibitor for the non-small cell lung cancer using FDG-PET/CT and thallium SPECT
Presenter: KAYOKO Kibata
Session: Poster display session
Resources:
Abstract
334P - Incidence and characteristic of adrenal insufficiency due to immune checkpoint inhibitors therapy
Presenter: Daisuke Etoh
Session: Poster display session
Resources:
Abstract
335P - PD-L1 profile of nasopharyngeal cancer patients in Indonesia
Presenter: Handoko Handoko
Session: Poster display session
Resources:
Abstract
336P - Pembrolizumab plus chemotherapy versus pembrolizumab monotherapy for PD-L1-positive advanced non-small cell lung cancer in the real world
Presenter: Jun Sugisaka
Session: Poster display session
Resources:
Abstract
337P - Neutrophil-to-Lymphocyte ratio as a predictive factor for hyperprogressive disease in NSCLC patients treated with immune checkpoint inhibitor
Presenter: Ryo Takahashi
Session: Poster display session
Resources:
Abstract
338P - A new insight into tumour immune-evasion: Crosstalk between cancer stem cells and T regulatory cells
Presenter: Abhishek Dutta
Session: Poster display session
Resources:
Abstract
339TiP - PACIFIC-5: Phase III study of durvalumab after either concurrent or sequential chemoradiotherapy (CRT) in patients with stage III NSCLC
Presenter: Yi-Long Wu
Session: Poster display session
Resources:
Abstract