Abstract 334P
Background
Immune checkpoint inhibitors (ICI) have been approved for non-small lung cancer (NSCLC). Adrenal insufficiency (AI) is a distinctive adverse event related to ICI. This can be either primary adrenal gland destruction or interference with corticotrophin (ACTH) secretion by the pituitary gland (secondary). As AI is relatively rare and symptoms and signs of AI are non-specific, the diagnosis of AI is often difficult. To clear the incidence and characteristics of AI related with ICI. We conducted a retrospective single center study.
Methods
We reviewed the medical records of patients with NSCLC who received pembrolizumab, nivolumab, atezolizumab or duravalmab at JCHO Kyushu Hospital between Feb 2017 and Jun 2019.
Results
A total of 114 patients with NSCLC received ICI. Eight patients (7.0%) were diagnosed with AI. Median age was 67 (range: 54 to 79). Six were male. Six out of eight patients were secondary AI, one patient was primary AI, and one patient was unknown. The median onset of AI from the first dose of ICI was 203 days (range: 38 to 763). The patients presented with fatigue, fever, nausea, diarrhea and/or dizziness. One patient was diagnosed because of repeating COPD/asthma attack. Hypocholesterolemia, hyponatremia, eosinophilia, hypoglycemia, and hyperkalemia were found 4, 2, 3, 1 and 1 out of 8 patients respectively. One patient didn’t exhibit any above symptom. All of the patients had rapid resolution of symptoms after hydrocortisone replacement.
Conclusions
ICI-associated AI developed in 7.0% of patients requiring hydrocortisone replacement therapy. Symptoms and laboratory abnormalities at the time of onset varied. It is thought that patients using ICI therapy will further increase in the future, and patients who develop ICI-related AI will also increase. Clinicians should deepen their understanding of the nature of AI and provide appropriate information to patients so that AI can be quickly diagnosed and treated.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
27P - The prognostic value of neutrophil to lymphocyte ratio (NLR) and 18F-FDG PET SUV in breast cancer patients underwent neoadjuvant chemotherapy
Presenter: Soong June Bae
Session: Poster display session
Resources:
Abstract
28P - Accuracy of core biopsy in predicting pathologic complete response in the breast in patients with complete/near complete clinical and radiological response (Complete Responders in the Breast – CRBr): A feasibility study
Presenter: Nisha Hariharan
Session: Poster display session
Resources:
Abstract
29P - Tumour response to neoadjuvant chemotherapy in breast cancer: Routine pathologic markers improve the predictive power of a cell-loss metric based on release of thymidine kinase 1 into blood
Presenter: Bernhard Tribukait
Session: Poster display session
Resources:
Abstract
30P - Comparison of metabolic changes between neoadjuvant chemotherapy and neoadjuvant endocrine therapy in premenopausal women with ER positive, HER2 negative breast cancer
Presenter: Ho-hyun Ryu
Session: Poster display session
Resources:
Abstract
31P - Circulating miR-155 as a potential therapeutic monitoring marker in breast cancer
Presenter: Sumadi Lukman Anwar
Session: Poster display session
Resources:
Abstract
32P - Profile of breast cancer epidemiology in Sanglah General Hospital, Denpasar, Bali from 2012 to 2019
Presenter: Citra Aryanti
Session: Poster display session
Resources:
Abstract
33P - Contrast enhanced chest CT in patients with breast cancer: Comprehensive imaging analysis and correlation with biological markers
Presenter: Bo Hwa Choi
Session: Poster display session
Resources:
Abstract
34P - Verification of metabolic regulatory mechanisms in androgen receptor-positive triple negative breast cancer
Presenter: Yuka Asano
Session: Poster display session
Resources:
Abstract
35TiP - Ribociclib plus goserelin with hormonal therapy versus physician choice chemotherapy in pre-/perimenopausal patients with HR+, HER2– inoperable locally advanced breast cancer (ABC): RIGHT choice study
Presenter: Yen-Shen Lu
Session: Poster display session
Resources:
Abstract
36TiP - A prospective study to assess response to neoadjuvant hormonal therapy in postmenopausal women with hormone-receptor positive breast cancer at a regional cancer centre in South India
Presenter: Shina Goyal
Session: Poster display session
Resources:
Abstract