1182 - Interstitial lung disease induced by immune-checkpoint inhibitors correlates with prognosis of advanced non-small-cell lung cancer patients

Background

Interstitial lung disease (ILD) induced by immune checkpoint inhibitors (ICIs) is a potentially life-threatening adverse event. The purpose of this study was to evaluate whether the development of immune-related adverse events (irAEs), especially ILD associates with treatment efficacy and to research the characteristics of ILD in advanced non-small-cell lung cancer (NSCLC).

Methods

Between December 2015 and November 2018, 132 advanced NSCLC patients were treated with nivolumab, pembrolizumab or atezolizumab. The patients were categorized into two groups (irAEs group or non-irAEs group). Subsequently, we extracted patients based on the incidence of ILD (ILD group). Treatment efficacy and characteristics of ILD were evaluated in each group.

Results

The 39 (30%) patients developed irAEs. ILD was observed in 16 (12%) patients. Patients with ILD had significantly higher objective response rate (ORR) compared with irAEs-non-ILD patients and non-irAEs patients (63%, 43% and 22%, respectively). Median progression-free survival (mPFS) was 15.9 months in the ILD patients, 5.4 months in the irAEs-non-ILD patients and 3.3 months in the non-irAEs patients (Log rank, P = 0.035). Pre-existing interstitial pneumonia (IP) was an independent risk factor of ILD-induced ICIs (odds ratios 15.1; 95% CI: 2.23-102, P = 0.005).

Conclusions

ORR and PFS were significantly better in the ILD patients than in the irAEs-non-ILD and non-irAEs patients. Pre-existing history of IP was an independent risk factor of ILD-induced ICIs.

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.