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
1242 - Monalizumab in combination with cetuximab in patients (pts) with recurrent or metastatic (R/M) head and neck cancer (SCCHN) previously treated or not with PD-(L)1 inhibitors (IO): 1-year survival data.
Presenter: Roger Cohen
Session: Poster Display session 3
Resources:
Abstract
4703 - Updated results of a phase II study evaluating accelerator-based boron neutron capture therapy (AB-BNCT) with borofalan(10B) (SPM-011) in recurrent squamous cell carcinoma (R-SCC-HN) and recurrent and locally advanced non-SCC (R/LA-nSCC-HN) of the head and neck
Presenter: Katsumi Hirose
Session: Poster Display session 3
Resources:
Abstract
3638 - Phase 3 KEYNOTE-048 Study of First-Line (1L) Pembrolizumab (P) for Recurrent/Metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC): Asia vs Non-Asia Subgroup (subgrp) Analysis
Presenter: Makoto Tahara
Session: Poster Display session 3
Resources:
Abstract
2954 - Integrated data review evaluating safety, pharmacokinetics (PK) and immunogenicity of RM-1929 photoimmunotherapy (PIT) in subjects with locoregional, recurrent head and neck squamous cell carcinoma (rHNSCC).
Presenter: Jennifer Johnson
Session: Poster Display session 3
Resources:
Abstract
3629 - First line versus second line immunotherapy in recurrent/metastatic squamous cell carcinoma of the head and neck
Presenter: Caroline Even
Session: Poster Display session 3
Resources:
Abstract
767 - Sensitizing HRAS overexpressing head and neck squamous cell carcinoma (HNSCC) to chemotherapy
Presenter: Theodoros Rampias
Session: Poster Display session 3
Resources:
Abstract
4985 - A Single-Arm, Open-Label, Multicenter, Phase IIIb Clinical Trial with Nivolumab in Subjects with Recurrent or Metastatic Platinum-refractory Squamous Cell Carcinoma of the Head and Neck.
Presenter: Paolo Bossi
Session: Poster Display session 3
Resources:
Abstract
1564 - Long-term Results of Phase 2 Trial of Reduced Modified Clinical Target Volume in Low-risk Nasopharyngeal Carcinoma Treated with Intensity Modulated Radiotherapy
Presenter: Jingjing Miao
Session: Poster Display session 3
Resources:
Abstract
3356 - To compare two oral mucosa contouring methods in predicting acute oral mucocitis in nasopharyngeal carcinoma treated with helical tomotherapy
Presenter: Yuan-Yuan Chen
Session: Poster Display session 3
Resources:
Abstract
1984 - Induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC)
Presenter: Gizem Kaval
Session: Poster Display session 3
Resources:
Abstract