Abstract 3836
Background
Thyroid dysfunction is one of the most common adverse effects during anti-PD-1 therapy, and alongside elevated anti-thyroid antibodies (ATAb) it is correlated with overall (OS) and progression free survival (PFS). The objective and novelty of our study was the simultaneous investigation of thyroid dysfunction and ATAbs on survival.
Methods
We included 168 patients with non-small cell lung carcinoma (n = 93), renal cell carcinoma (n = 12), and advanced and metastatic melanoma (n = 63) treated with nivolumab or pembrolizumab. TSH and fT4 serum levels were measured prior to each anti-PD-1 infusion and ATAb titers in sera, i.e. anti-TPO and anti-Tg (cut-off: 3.05 IU/ml and 22.35 IU/ml, respectively; based on median value at baseline), at baseline, and after 2 months of treatment. Thyroid dysfunction was based on TSH and fT4 and classified as subclinical or overt. Tumor progression was classified according to RECIST v1.1 and was monitored until progression, death or withdrawal of the study. Cox regression was used with correction for tumor type.
Results
Patients who acquired overt thyroid toxicity during anti-PD-1 treatment had significantly higher OS (HR = 0.17 [95% CI: 0.04-0.74]; p = 0.018) and PFS (HR = 0.38 [0.15-0.98]; p = 0.05) than patients without thyroid toxicity with one-year OS rates of 95% vs 64% and one-year PFS rates of 65% vs 33%. Moreover, patients with positive ATAb status during treatment had higher OS (HR = 0.39 [0.21-0.72]; p = 0.003) and PFS (HR = 0.52 [0.33-0.81]; p = 0.004) than patients with negative ATAb status with one-year OS rates of 83% vs 49% and PFS rates of 54% vs 20%, respectively. For 84% of patients the ATAb status at baseline was the same as during treatment. Patients with persistent positive ATAb status (48%) had higher OS (HR = 0.41 [0.19-0.89], p = 0.03) and PFS (HR = 0.54 [0.31-0.95], p = 0.03) compared to patients with persistent negative ATAb status (36%).
Conclusions
Acquired overt thyroid toxicity and positive ATAb status during anti-PD-1 treatment are associated with improved PFS and OS. Moreover, our results indicate that ATAb status at baseline is of clinical relevance for PFS and OS. If validated, these parameters may serve as a novel positive predictive markers.
Clinical trial identification
Dutch trial register: MULTOMAB, NL6828.
Editorial acknowledgement
Legal entity responsible for the study
Erasmus Medical Center.
Funding
Erasmus Medical Center.
Disclosure
A.A.M. Van der Veldt: Advisory / Consultancy: Bristol-Myers Squibb; Advisory / Consultancy: Merck Sharp & Dohme. R.H. Mathijssen: Research grant / Funding (institution), Travel / Accommodation / Expenses: Astellas; Research grant / Funding (institution): Bayer; Research grant / Funding (institution): Boekringer; Research grant / Funding (institution): Cristal Therapeutics; Honoraria (self), Research grant / Funding (institution): Novartis; Research grant / Funding (institution): Pamgene; Research grant / Funding (institution), Travel / Accommodation / Expenses: Pfizer; Research grant / Funding (institution): Roche; Research grant / Funding (institution): Sanofi; Honoraria (self): Servier. All other authors have declared no conflicts of interest.
Resources from the same session
2494 - CAR-T Nursing Education at a UK Specialist Cancer Hospital
Presenter: Rose Ellard
Session: Poster Display session 3
Resources:
Abstract
2438 - Professional Quality of Life, Perceived Stress and Psychological Resistance Levels of Oncology-Hematology Nurses and the Factors Affecting
Presenter: Tugba Pehlivan
Session: Poster Display session 3
Resources:
Abstract
3541 - Representation of cancer survivors’ preferences in policies for supportive care: Implications for oncology nursing
Presenter: Samantha Mayo
Session: Poster Display session 3
Resources:
Abstract
5093 - Vaginal moisturizing post PDR-Pulse Dose Rate Brachytherapy.
Presenter: Pilar Fernández
Session: Poster Display session 3
Resources:
Abstract
1066 - The stomized, chemo and radiotreated patient vs untreated patient: complications and comparison with data literature
Presenter: Cristoforo Ferrero
Session: Poster Display session 3
Resources:
Abstract
1724 - Evaluating the role of clinical nurse specialist
Presenter: Anita Zeneli
Session: Poster Display session 3
Resources:
Abstract
3753 - Role of the Advanced Practice Nurse (APN) in a Functional Unit for Lung cancer at the Catalan Institute of Oncology
Presenter: Isabel Brao
Session: Poster Display session 3
Resources:
Abstract
2676 - A bottom-up approach for prioritising the scientific activities of the Italian Association of Cancer Nurses (AIIAO): rationale and topic identification
Presenter: Valentina Biagioli
Session: Poster Display session 3
Resources:
Abstract
575 - Investigating quality of care for people with cancer and dementia
Presenter: Naomi Farrington
Session: Poster Display session 3
Resources:
Abstract
5578 - Two years of BRCA1 and BRCA2 somatic External Quality Assessment with Gen&tiss Tiss scheme in France
Presenter: Kelly Dufraing
Session: Poster Display session 3
Resources:
Abstract