Abstract 1572
Background
With increasing use of immunotherapy and targeted treatments in oncology, it is essential to understand the biological effects of these therapies on tumor kinetics. This retrospective review aims to identify hyperprogressive disease (HPD) occurrence in sarcoma patients treated with immunotherapy or targeted therapy, and its effect on overall survival.
Methods
We performed a retrospective review of advanced sarcoma patients enrolled in immunotherapy or targeted therapy clinical trials at the Princess Margaret Cancer Centre, Toronto. Tumor growth rate (TGR) was assessed for each patient based on serial CT scans at pre-baseline, baseline and on-treatment timepoints. TGR was calculated using a published formula (Champiat et al. 2017), and the ratio between reference and experimental groups was then calculated. The predictive accuracy of HPD was assessed using Cox proportional hazards analysis both as a continuous variable and using a cut-off for TGR ratio percentage of more than 50%. Statistical significance was defined as p < 0.05.
Results
We identified 146 patients who were treated with immunotherapy, targeted therapy, or combination chemotherapy and targeted therapy between July 26, 2013, and August 7, 2018. 106 patients met the eligibility criteria. 20 patients received immunotherapy, 86 patients received targeted or combination chemotherapy and targeted therapy. Three patients from the immunotherapy group had HPD (15%), and two patients from the non-immunotherapy group had HPD (2.3%). The hazard ratio for the patients with TGR ratio percentage of ≥ 50%(HPD) was 9.34 (95% CI 3.38-25.84, p = < 0.001). The median survival in all patients with HPD vs non-HPD was 3.9 months (95% CI 2.5-5.2 months) vs 16.1 months (95 % CI 13-19.2 months). There was no interaction between HPD and receipt of immunotherapy vs other therapy.
Conclusions
There is a correlation between TGR and clinical outcomes in patients with sarcoma treated with immunotherapy or targeted therapy. HPD is associated with worse survival outcomes and may serve as a useful tool in the assessment of treatment futility during patient therapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Abdul Razak Ryan Albiruni.
Funding
Has not received any funding.
Disclosure
E. Amir: Speaker Bureau / Expert testimony: Genentech/Roche; Honoraria (self): Apobiologix ; Advisory / Consultancy: Agendia; Advisory / Consultancy: Myriad Genetics. A.R.R. Albiruni: Honoraria (self): Boehringer Ingelheim ; Advisory / Consultancy: Lilly; Advisory / Consultancy: Merck; Advisory / Consultancy: Boehringer Ingelheim; Research grant / Funding (self): CASI Pharmaceuticals; Research grant / Funding (self): Lilly; Research grant / Funding (self): Novartis; Research grant / Funding (self): Deciphera; Research grant / Funding (self): Karyopharm Therapeutics; Research grant / Funding (self): Pfizer; Research grant / Funding (self): Roche/Genentech; Research grant / Funding (self): Boston Biomedical; Research grant / Funding (self): Bristol-Myers Squibb; Research grant / Funding (self): MedImmune; Research grant / Funding (self): Amgen; Research grant / Funding (self): GlaxoSmithKline; Research grant / Funding (self): Blueprint Medicines; Research grant / Funding (self): Merck; Research grant / Funding (self): AbbVie; Research grant / Funding (self): Adaptimmune. All other authors have declared no conflicts of interest.
Resources from the same session
2182 - Evaluating the prevalence of the expression of PD-L1 in NSCLC specimens with short-duration formalin fixation using IHC 22C3 pharmDx
Presenter: Keiichi Ota
Session: Poster Display session 1
Resources:
Abstract
5255 - [18F]-FDG PET/CT in predicting PD-L1 status in nasopharyngeal carcinoma
Presenter: Liang Zhao
Session: Poster Display session 1
Resources:
Abstract
4910 - Expression of PD-L1 in Chinese Patients with Common Cancers
Presenter: Min Zheng
Session: Poster Display session 1
Resources:
Abstract
4227 - The clearance of EGF by tumor-associated macrophages is suppressed by chemotherapeutic agent cisplatin
Presenter: Irina Larionova
Session: Poster Display session 1
Resources:
Abstract
5222 - VHIO-300 and a thousand one nights, a tale of Precision Medicine
Presenter: Ginevra Caratù
Session: Poster Display session 1
Resources:
Abstract
5668 - Matched Whole-Genome Sequencing and Whole-Exome Sequencing with Circulating Tumor DNA (ctDNA) Analysis are complementary modalities in clinical practice
Presenter: Robin Imperial
Session: Poster Display session 1
Resources:
Abstract
5772 - Exploring the role of genes associated with familial cancer syndromes on the development of multiple primary tumors
Presenter: Atanaska Mitkova
Session: Poster Display session 1
Resources:
Abstract
4784 - Doxorubicin resistance: early and advanced tumors can use two different strategies based on initial and profound abnormalities in microRNA expression signature
Presenter: Volodymyr Halytskiy
Session: Poster Display session 1
Resources:
Abstract
3456 - From tumor transcriptomes to underlying cell type proportions to better predict prognosis and response to treatments
Presenter: Yuna Blum
Session: Poster Display session 1
Resources:
Abstract
4976 - Optimization of automated germline DNA extraction from non-tumoral formalin-fixed paraffin embedded (FFPE) tissues
Presenter: Omar Youssef
Session: Poster Display session 1
Resources:
Abstract