Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster Display session 3

5031 - Sarcoidosis-Like Reaction Mimics Progression in patients treated with immune checkpoint inhibitors

Date

30 Sep 2019

Session

Poster Display session 3

Topics

Immunotherapy

Tumour Site

Presenters

Sophie Hans

Citation

Annals of Oncology (2019) 30 (suppl_5): v475-v532. 10.1093/annonc/mdz253

Authors

S. Hans1, L. Dercle2, S. Champiat3, A. Voisin4, C. Noémie5, A. Marabelle6, J. Michot7, L. Sara1, B. Corinne1, S. Ammari8

Author affiliations

  • 1 Radiology, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 2 Radiology, Columbia University Medical Center/New York Presbyterian Hospital, 10032 - New York/US
  • 3 Drug Development Department (ditep), Gustave Roussy, 94805 - Villejuif/FR
  • 4 Pharmacovigilance, Gustave Roussy, 94805 - Villejuif/FR
  • 5 Internal Medicine, Bicêtre Hospital, 94270 - Kremlin Bicêtre/FR
  • 6 Drug Development Department, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 7 Drug Developpement Department, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 8 Radiology, Gustave Roussy, 94805 - Villejuif/FR

Resources

Login to access the resources on OncologyPRO.

If you do not have an ESMO account, please create one for free.

Abstract 5031

Background

The use of immune checkpoint inhibitors (ICI) has revealed a new panel of tumor response and adverse events. Immune-related sarcoidosis-like reactions is frequently misdiagnosed as progressive or recurrent disease. This study aims to decipher the diagnosis hallmark of immune-related sarcoidosis-like reactions as well as its association with patients’ outcome.

Methods

From August 2014 and December 2018, in a centralized single center review, we retrospectively included all patients with histologically proven immune-related sarcoidosis-like reaction during a treatment with ICI in monotherapy or combination. 54 variables were retrospectively recorded: clinical (n = 17), biological (n = 11) and radiological (n = 26), as well as the objective response to treatment using the best overall response according to iRECIST.

Results

Out of 3,200 patients treated with ICI, a total of 18 histologically proven sarcoidosis were diagnosed. The majority were female patients (n = 11/18) treated for melanoma (n = 14/18) or clear renal cell carcinoma (n = 3/18). The median [range] time to diagnosis of a sarcoidosis-like reaction was 30 [5-126] weeks after ICI treatment initiation. On CT-scans, the most common radiological findings were: absence of radiographical progression of the primary tumor per RECIST1.1 (100%), bilateral symmetrical mediastinal lymphadenopathy (100%), symmetrical hilar lymphadenopathy (84%), and micronodules with lymphatic distribution (15%). On PET-CT, an extrathoracic glucose uptake was observed in 65% of patients. The sites involved were pleural involvement, abdominal lymph nodes, liver, and spleen. Patients with immune-related sarcoidosis-like reactions were objective responders according to iRECIST in 84% (n = 15/18) of patients, while only 15% had stable disease.

Conclusions

Immune-related sarcoidosis is characterized by the appearance of new mediastinal and/or pulmonary lesions, usually at 30 weeks after initiation of treatment, with stability of baseline target lesions. PET/CT demonstrated extrathoracic uptake in 65% of patients. This should not be misinterpreted as disease progressive since 84% of patients will show an objective response to ICI.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Ammari Sami.

Funding

Has not received any funding.

Disclosure

S. Champiat: Advisory / Consultancy: Astrazenaca; Advisory / Consultancy: BMS; Advisory / Consultancy: Janssen; Advisory / Consultancy: MSD; Advisory / Consultancy: Roche. J. Michot: Advisory / Consultancy: BMS. All other authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.