356O - Construction of an immune-related adverse events prediction model for teripulimab in the treatment of recurrent metastatic nasopharyngeal carcinoma and its analysis with survival prognosis

Background

Clinical trial data have shown that programmed cell death 1 (PD-1) inhibitors can be effective in patients with recurrent or metastatic nasopharyngeal carcinoma (RM-NPC). A subset of patients experiences immune-related adverse events (irAEs), several studies have reported the incidence of irAEs as a predictor of the efficacy of αPD-1 antibodies in patients with cancer. However, clinical predictive factors for treatment responses or irAEs risk remain unclear. Our objective was to develop a nomogram that utilizes pre-treatment peripheral blood signatures to predict the risk of irAEs in patients with RM-NPC.

Methods

Clinical data including age, sex, clinical type, metastatic site, treatment course, blood laboratory tests, irAEs and treatment outcome were collected. Data were randomly divided into a training and a validation set (ratio: 7:3). The predictive value of the irAEs nomogram was evaluated using time-dependent area under the curve, decision curve analysis, and calibration curve. According to irAEs nomogram, patients with high risk of irAEs were compared with those with low risk of irAEs in terms of overall survival (OS) and progression-free survival (PFS).

Results

In total, 336 patients were enrolled with 236 and 100 in the training and validation cohorts, respectively. Multivariate logistic regression analysis showed that increased baseline neutrophil lymphocyte ratio (NLR) was significantly associated with high risk of irAEs (odds ratio [OR]: 2.7, P = 0.002, cutoff value = 4.337). Four peripheral blood indicators (monocyte, NLR, free T4, and plasma Epstein-Barr virus (EBV) DNA titer) and ICI duration, were included to construct the irAEs signature. We constructed and validated a irAEs nomogram in combination with five above clinical characteristics, which showed favourable performance. Patients in the high-risk irAEs group had significantly better overall and progression-free survival than patients in the low-risk group in both cohorts (P < 0.05).

Conclusions

This study of irAEs in patients with RM-NPC who are receiving toripalimab suggests that high risk of irAEs was associated with improved survival.

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.