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 types | ORR | Comments |
---|---|---|
Urinary tract cancers | 7/8(87.5%) | With Avastin and chemotherapy |
Esophageal cancer | 9/15(60%) | Afatinib with anti-PD1 |
NSCLC | 19/32(59%) | KN189/IMpower150 in Adeno; CM227 in SCC |
HNSCC | 14/30(47%) | Afatinib with anti-PD1(easy autoimmune cholestasis and interstitial pneumonitis with pembrolizumab) |
HCC | 9/36(25%) | With metronomic therapy, Avastin, or chemotherapy |
SCLC | 1/2(50%) | +/-Avastin |
NPC | 2/5(40%) | Biomarkers needed |
GC | 1/6(17%) | Responder in MSI-H |
Papilla of Vater cancer | 1 stable disease | HER2 amplification and high TMB |
Skin cancer | 1/1 | High TMB |
Cholangiocarcinoma | 0/3 | Combinations searching |
RCC | 1/1 | With anti-angiogenesis Tx |
PCNSL | 1/1 | Rituximab 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.
Resources from the same session
143P - NOTCH3 expression predicts poor survival in advanced esophageal squamous cell cancers
Presenter: Raja Pramanik
Session: Poster display session
Resources:
Abstract
144P - Severe hypovitaminosis D in metastatic gastric cancer patients from the Northern and Southern hemispheres: Data from the EXPAND phase III trial
Presenter: Radka Obermannova
Session: Poster display session
Resources:
Abstract
145P - Role of Glasgow prognostic score in chemo-naïve patients with advanced biliary tract cancer and good performance status
Presenter: Toshikazu Moriwaki
Session: Poster display session
Resources:
Abstract
146P - Anatomic versus non-anatomic resection for hepatocellular carcinoma: A meta-analysis of high-quality studies
Presenter: Bin Zhang
Session: Poster display session
Resources:
Abstract
147P - Clinical outcomes of proximal gastrectomy versus total gastrectomy for locally advanced proximal gastric cancer: a propensity score matching analysis
Presenter: Yingtai Chen
Session: Poster display session
Resources:
Abstract
148P - Efficacy of capecitabine and oxaliplatin versus S-1 as adjuvant chemotherapy in gastric cancer after D2 lymph node dissection according to lymph node ratio and N stage
Presenter: Seunghwan Lee
Session: Poster display session
Resources:
Abstract
150P - A Phase Ib Study of IMU-131 HER2/neu peptide vaccine plus chemotherapy in patients with HER2/neu overexpressing metastatic or advanced adenocarcinoma of the stomach or gastroesophageal junction
Presenter: Yee Chao
Session: Poster display session
Resources:
Abstract
151P - Gene expression profiling for a better understanding of gastric cancer: From the perspective of metabolic rearrangement
Presenter: Midie Xu
Session: Poster display session
Resources:
Abstract
152P - Long-term outcomes of three-dimensional conformal radiotherapy-based and intensity-modulated radiotherapy-based concurrent chemoradiotherapy in patients with thoracic esophageal squamous cell carcinoma
Presenter: Chia-Lun Chang
Session: Poster display session
Resources:
Abstract
153P - Exosomal LINC00174 facilitates epithelial-mesenchymal transition in residual hepatocellular carcinoma after insufficient radiofrequency ablation by regulating c-JUN/MYCBP/c-Myc axis
Presenter: Dening Ma
Session: Poster display session
Resources:
Abstract