Abstract 5944
Background
Disruption of the immune system using immune checkpoint inhibitors (ICI) can result in a multitude of immune-related adverse effects (irAE). While irAEs have been well-reported in clinical trials, the impact and magnitude in the real world is unclear.
Methods
Data was collected on patients with advanced malignancy who experienced a suspected irAE requiring admission to an academic hospital (02/11-10/18). Each case was comprehensively reviewed by a minimum of two reviewers, including one sub-specialist.
Results
From 2011-2018, there were 632 hospitalizations for suspected irAEs, and the majority (59.7%; N = 377) were confirmed irAEs from immunotherapy: PD1 (N = 194, 51.5%), CTLA4 (N = 92, 24.4%), CTLA4 + PD1 (N = 76, 20.2%), PLD1 (N = 15, 4.0%). The most common irAEs were gastrointestinal (37.4%), pulmonary (14.9%), hepatic (13.5%), endocrine (16.2%), neurologic (9.0%), cardiac (6.9%), dermatologic (5.6%), rheumatologic (2.9%), hematologic (2.1%), renal (1.9%), and allergy (1.1%). 10.3% of admissions had multiple toxicities. Median length of stay was 5 days (IQR, 3-8). Majority of patients (89.1%) required continuation of immunosuppressive medication on discharge. Inpatient toxicity led to ICI discontinuation in 78.1% of admissions. Overall, there were 11.3 irAE admissions per 100 patients treated with ICI and 2.1 irAE admissions per 100 ICI administrations.
Conclusions
irAEs from ICI can result in prolonged hospitalizations, need for immunosuppression, and ICI discontinuation, which can have detrimental effects on oncologic outcomes. Consequently, there is a critical need for coordinated multidisciplinary approach, comprehensive provider education, and translational research programs for early detection and intervention.
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
2316 - A 3D co-culture platform of breast cancer and patient derived immune cells to analyse the response to chemotherapy and immunotherapies
Presenter: Diana Saraiva
Session: Poster Display session 3
Resources:
Abstract
4290 - Characterization of the mechanism of action and efficacy of MEN1611 (PA799), a novel PI3K inhibitor, in breast cancer preclinical models.
Presenter: Alessio Fiascarelli
Session: Poster Display session 3
Resources:
Abstract
2167 - Neat-1: culprit lnRNA tying PIG-C, MSLN, CD80 in TNBC
Presenter: Nada Hussein
Session: Poster Display session 3
Resources:
Abstract
1829 - A novel RAF/MEK inhibitor CH5126766 in phase 1 clinical trial has an effectiveness in the combination with eribulin for the treatment of triple negative breast cancer
Presenter: Hisako Ono
Session: Poster Display session 3
Resources:
Abstract
4357 - Identification of a stemness-related gene panel associated with BET inhibition in triple negative breast cancer
Presenter: Eva Galan-Moya
Session: Poster Display session 3
Resources:
Abstract
5163 - Preclinical Evaluation targeting both IGF1R and IR in Triple Negative Breast Cancer
Presenter: Alex Eustace
Session: Poster Display session 3
Resources:
Abstract
832 - Monospecific antibody targeting of CDH11 inhibits epithelial-to-mesenchymal transition and represses cancer stem cell-like phenotype by up-regulating miR-335 in metastatic breast cancer, in vitro and in vivo.
Presenter: Jia-Hong Chen
Session: Poster Display session 3
Resources:
Abstract
3781 - Pharmacological screening with Chk1 inhibitors identify synergistic agents to overcome resistance to platinums in basal breast and ovarian cancer
Presenter: Ana Lucia Sanabria
Session: Poster Display session 3
Resources:
Abstract
3275 - Comparison of 11 circulating miRNAs and CA125 kinetics in ovarian cancer during first line treatment: data from the randomized CHIVA trial (a GINECO-GCIG study)
Presenter: Patrick Robelin
Session: Poster Display session 3
Resources:
Abstract
3391 - Inhibiting Ehmt2 and Ezh2 histone methyltransferases alters the immune microenvironment in a Trp53-/- murine ovarian cancer model
Presenter: Pavlina Spiliopoulou
Session: Poster Display session 3
Resources:
Abstract