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.
Resources from the same session
4868 - Evaluation of markers associated with efficacy of abiraterone acetate plus prednisone (AAP) in patients (pts) with castration-sensitive prostate cancer (mCSPC) from the LATITUDE study
Presenter: Kim Chi
Session: Poster Display session 3
Resources:
Abstract
4837 - LRP2, a potential new biomarker for Chinese younger aged intrahepatic cholangiocarcinoma patients
Presenter: Xiaoliang Shi
Session: Poster Display session 3
Resources:
Abstract
1286 - Reanalysis of the efficacy of molecular targeted agents (MTAs) given in the randomized trial SHIVA01 according to the ESMO ESCAT scale of actionability
Presenter: Aurelie Moreira
Session: Poster Display session 3
Resources:
Abstract
2736 - Comparison of Platforms for Determining Tumor Mutational Burden (TMB) From Blood Samples in Patients With Non-Small Cell Lung Cancer (NSCLC)
Presenter: Jonathan Baden
Session: Poster Display session 3
Resources:
Abstract
5045 - Comprehensive Pan-Cancer analysis of somatic mutations in drug transporters to reveal acquired and intrinsic drug resistance in 3149 metastatic cancer patients
Presenter: Sander Bins
Session: Poster Display session 3
Resources:
Abstract
4577 - Pan-Cancer Genomic Landscape of the Cyclin D1/FGF3,4,19 (11q13) Amplicon Including Associations with HPV Status, and ESR1 and AR Alterations
Presenter: Jennifer Johnson
Session: Poster Display session 3
Resources:
Abstract
5366 - Co-occurrence of NTRK fusions with other genomic biomarkers in cancer patients
Presenter: Xiaolong Jiao
Session: Poster Display session 3
Resources:
Abstract
4084 - Prospective comparative study of next-generation sequencing on fine needle aspirations versus core needle biopsies in cancer patients included in SHIVA02 trial
Presenter: Julien Masliah-Planchon
Session: Poster Display session 3
Resources:
Abstract
6017 - First national External Quality Assessement for the interpretation of somatic variants: assessment of 25 variants in colorectal, lung, ovarian cancers and melanoma in France
Presenter: Etienne Rouleau
Session: Poster Display session 3
Resources:
Abstract
2283 - Prospective testing of circulating tumor DNA in metastatic breast cancer facilitates clinical trial enrollment and precision oncology
Presenter: Andjelija Bujak
Session: Poster Display session 3
Resources:
Abstract