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
4658 - Patient-reported outcomes associated with switching to rivaroxaban for the treatment of venous thromboembolism (VTE) in patients with active cancer
Presenter: Alexander Cohen
Session: Poster Display session 1
Resources:
Abstract
5638 - Incidence of Vascular Thromboembolism Events in Cancer Patients Receiving Immunotherapy: A Single Institution Experience.
Presenter: Laura Gutiérrez Sainz
Session: Poster Display session 1
Resources:
Abstract
5182 - High Incidence of Venous Thromboembolic Events (VTE) in Patients with Diffuse Large B-Cell Lymphoma.
Presenter: Alaa Abufara
Session: Poster Display session 1
Resources:
Abstract
1504 - Weight Loss over Time in Non-Small Cell Lung Cancer: Results from a Landmark Analysis of 800+ Prospectively-Treated Patients
Presenter: Jennifer Le-rademacher
Session: Poster Display session 1
Resources:
Abstract
3972 - The prognostic significance of preoperative nutritional status in resected pancreatic ductal adenocarcinoma (PDAC).
Presenter: Salvatore Paiella
Session: Poster Display session 1
Resources:
Abstract
2313 - Impact of Timing and Technique of Gastrostomy Placement on the Outcome of Patients (pts) with Head and Neck Cancer (HNC)
Presenter: M Julia Lostes Bardaji
Session: Poster Display session 1
Resources:
Abstract
5219 - Clinical & nutritional determinants of quality of life in patients with incurable cancer
Presenter: Louise Daly
Session: Poster Display session 1
Resources:
Abstract
4075 - Loss of skeletal muscle mass during palliative chemotherapy is a poor prognostic factor in patients with advanced gastric cancer
Presenter: In Gyu Hwang
Session: Poster Display session 1
Resources:
Abstract
4159 - Impact of nutritional derangement on treatment outcome in advanced non-small-cell lung cancer (A-NSCLC) patients (pts).
Presenter: Ilaria Trestini
Session: Poster Display session 1
Resources:
Abstract
1210 - Sarcopenia and pretreatment anemia as prognostic factors for patients with localized muscle invasive bladder cancer treated by neoadjuvant chemotherapy and radical cystectomy
Presenter: Emilien Billon
Session: Poster Display session 1
Resources:
Abstract