Abstract 3417
Background
Immune-checkpoint inhibitors (ICI) have recently been used in many types of cancers including non-small cell lung cancer (NSCLC). Interstitial lung disease associated with ICI (ICI-ILD) is a serious immune-related adverse event. However, comprehensive clinical characterization of ICI-ILD is still lacking.
Methods
We retrospectively analyzed clinical and imaging data of all consecutive ICI treated patients in Kurashiki Central Hospital (Okayama, Japan) between January 2016 and March 2019. We elucidated clinical characteristics, radiopathological patterns, therapeutic strategies and outcomes of ICI-ILD and analyzed the prognostic factor of ICI-ILD.
Results
Among 316 (222 NSCLC and 94 non-NSCLC) treated with ICI, 35 (11.1%) were diagnosed as ICI-ILD. Of those, NSCLC/gastric cancer/urinary cancer/head and neck cancer/malignant lymphoma were 26/2/2/4/1, respectively: mean age was 69.3 ± 9.0 years; 29 (82.9%) were men; 19 (54.3%) received Nivolumab monotherapy and 10 (28.6%) received Pembrolizumab monotherapy; Best objective response rate until ICI-ILD diagnosis was 48.6% (11/35); The median time (range) from ICI introduction to ICI-ILD was 57 (22-155) days. CTCAE grade 1/2/3 + 4/5 was 10 (28.6%)/14 (40.0%)/7 (20.0%)/4 (11.4%), respectively; Organizing pneumonia was found in 57.1% (20/35) in CT and 66.7% (4/6) in transbronchial lung biopsy; Lymphocyte differential count of bronchoalveolar lavage fluid (range) was 41 (33-60) %; 26 (74.3%) were treated with corticosteroid; 29 (82.9%) had ICI-ILD improved but 6 (17.1%) did not. The median survival time was significantly different between ILD improved group and non-improved group (17.1 months vs 0.8 months, p < 0.001). Multivariate Cox regression analysis demonstrated that only ICI-ILD improvement is a significant prognostic factor (HR: 0.03; 95% CI, 0.003-0.305; p = 0.003).
Conclusions
In our real-world experience, half of ICI-ILD patients had a response toward malignancy. Organizing pneumonia was the most common radiopathological pattern and lymphocyte differential count of bronchoalveolar lavage fluid was elevated in ICI-ILD. If ICI-ILD does not improve, its prognosis may be very poor.
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
3117 - A modified Edmonton Symptom Assessment Scale for assessing symptoms in one day chemotherapy clinic
Presenter: Anjuleta Kampitsi
Session: Poster Display session 3
Resources:
Abstract
6058 - Level of physical activity and nutritional status in cancer patients with fatigue: an exploratory cross-sectional study
Presenter: Patrick Jahn
Session: Poster Display session 3
Resources:
Abstract
1980 - Catheter related necrotizing fascitiis in haematological patients. Case report and implications for nursing
Presenter: Arianna Rosich Soteras
Session: Poster Display session 3
Resources:
Abstract
3984 - Everyday life with Long-term Chemotherapy Induced Peripheral Neuropathy among Patient in Adjuvant Treatment for Colorectal Cancer – a Multi Methods Study
Presenter: Marlene Jensen
Session: Poster Display session 3
Resources:
Abstract
2202 - Scalp cooler is effective in reducing chemotherapy-induced alopecia among breast cancer patients : a single institution experience
Presenter: Emilia Gianotti
Session: Poster Display session 3
Resources:
Abstract
5942 - Nursing management of fatigue in cancer patients: mixed methods study
Presenter: Angela Tolotti
Session: Poster Display session 3
Resources:
Abstract
2930 - Awareness of Nursing Students about the Warning Signs of Cancer
Presenter: Hatice Yakar
Session: Poster Display session 3
Resources:
Abstract
2978 - Assessment of quality of life in patients with cancer and diabetes 2 in Northern Greece.
Presenter: STYLIANI MICHALOPOULOU
Session: Poster Display session 3
Resources:
Abstract
3400 - Radiation dose variables related to the causes of skin toxicities in women with breast cancer: a study proposal
Presenter: EULALIA PUJOL
Session: Poster Display session 3
Resources:
Abstract
2156 - How should the symptoms be managed after breast cancer surgery? An example of mobile app
Presenter: AYDANUR AYDIN
Session: Poster Display session 3
Resources:
Abstract