Abstract 1851
Background
Immune checkpoint inhibitors can cause pneumonitis in lung cancer patients. The role of previous thoracic radiation therapy (TRT) as a risk factor is not clear. Furthermore, some patients show radiation recall pneumonitis (RRP) pattern. In this multicenter retrospective study, we analyzed the relationship of previous TRT and other potential risk factors with nivolumab-induced pneumonitis, and the characteristics of RRP.
Methods
Medical records of non-small cell lung cancer patients, who received nivolumab between December 2015 and March 2017, were retrospectively reviewed. Baseline clinical characteristics, incidence, and risk factors were analyzed at 5 hospitals. Person’s chi-square test and multivariate logistic regression analysis (age, sex, smoking history, treatment history of TRT, and performance status at the start of nivolumab treatment) were conducted to identify potential risk factors. Imaging analysis for RRP was conducted only for patients treated in National Cancer Center Hospital at the moment.
Results
A total of 669 patients were evaluated, and the incidences of all-grade and ≥ grade 2 pneumonitis were 8.9% (60/669) and 7.2% (47/669), respectively. Two (0.3%) patients died due to the pneumonitis. Incidences of pneumonitis were 12.9% (33/256) and 6.5% (27/413) in patients with and without previous TRT, respectively. History of previous TRT was associated with pneumonitis in multivariate analysis [odds ratio, 1.95; 95% confidence interval 1.13-3.34]. Chest imaging by computed tomography of some of those patients showed RRP pattern with pneumonitis infiltration occurring in the radiation field previously treated, and the direct relation was suggested. Incidences of RRP were 4.2% (4/95) among patients with history of previous TRT and 30.8% (4/13) among patients with previous TRT and who developed nivolumab-induced pneumonitis.
Conclusions
Increasing risk of nivolumab-induced pneumonitis was associated with treatment history of TRT. RRP pattern was one of the characteristic radiographic patterns of nivolumab-induced pneumonitis in patients with previous TRT.
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
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