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
4811 - Comprehensive genomic profiling of thymic carcinoma in a sample Chinese population
Presenter: Baohui Han
Session: Poster Display session 1
Resources:
Abstract
2045 - The analysis of treatment sequences and clinical outcomes of thymic carcinoma
Presenter: Arakaki Motoko
Session: Poster Display session 1
Resources:
Abstract
4785 - Transcriptomic Difference of Thymoma and Thymic Carcinoma
Presenter: Naixin Liang
Session: Poster Display session 1
Resources:
Abstract
2864 - A Phase II Trial of Preoperative Chemoradiotherapy and Pembrolizumab for Locally Advanced Esophageal Squamous Cell Carcinoma (ESCC)
Presenter: Seoyoung Lee
Session: Poster Display session 1
Resources:
Abstract
5015 - The study of tumor associated exosomes in crosstalk between esophageal carcinoma and lymphatic endothelial cells
Presenter: Weimin Mao
Session: Poster Display session 1
Resources:
Abstract
1339 - Up-regulation of IBSP expression predicts poor prognosis of Esophageal Squamous Cell Carcinoma patients
Presenter: Mingyue Wang
Session: Poster Display session 1
Resources:
Abstract
4083 - PD-L1 expression in primary tumour vs metastatic samples in the Phase 3 MYSTIC study in first-line metastatic (m) NSCLC
Presenter: Niels Reinmuth
Session: Poster Display session 1
Resources:
Abstract
5113 - Assessing the impact of subsequent checkpoint inhibitor (CPI) treatment on overall survival: post hoc analyses from the phase 3 JAVELIN Lung 200 study of avelumab vs docetaxel in platinum-treated locally advanced/metastatic non-small cell lung cancer (NSCLC)
Presenter: Fabrice Barlesi
Session: Poster Display session 1
Resources:
Abstract
4256 - Long-term avelumab treatment in patients with advanced non-small cell lung cancer (NSCLC): post hoc analyses from JAVELIN Solid Tumor
Presenter: Borys Hrinczenko
Session: Poster Display session 1
Resources:
Abstract
4305 - Effectiveness and safety of nivolumab in the treatment of lung cancer patients in France: Updated survival and subgroup analysis from the real-world EVIDENS study
Presenter: Fabrice Barlesi
Session: Poster Display session 1
Resources:
Abstract