Abstract 2823
Background
Androgen deprivation therapy (ADT) is a cornerstone of treatment for prostate cancer, but limited studies have been performed to investigate the association between ADT and immune alterations, such as autoimmune diseases and risk of second tumours, considering that androgens may also play a role in the immune modulation.
Methods
We retrospectively evaluated patients (pts) treated with abiraterone (abi) and enzalutamide (enza) in 12 Italian Institutes between July 2011 and December 2018. In particular, we assessed the risk of systemic or single-organ autoimmune diseases [according to the International Classification of Diseases 10th Revision (ICD-10)] and second tumors, by performing a logistic regression analysis.
Results
We included 844 pts receiving abi/enza, whose 36 (4.3%) had diagnosis of autoimmune diseases at baseline [13 (1.5%) arthritis (rheumatoid or psoriatic), 12 (1.4%) autoimmune thyroiditis, 4 (0.5%) gastrointestinal autoimmune disease, 4 (0.5%) psoriasis, and 3 (0.4%) vasculitis] and 58 (6.9%) had second tumors (45 solid and 13 hematological). Median age was 70 years [interquartile range (IQR) 63-75]. Median duration of hormone sensitive of prostate cancer was 29 months (IQR 14-59), while median CRPC duration was 22 months (IQR 13-39). Most pts (N = 764, 90.5%) did ≤ 2 therapeutic lines, whose 477 (56.5%) and 367 (43.5%) were treated with abi and enza, respectively, and 359 (42.5%) were chemotherapy naive.
We observed a significant increase in the risk of autoimmune diseases and a trend for higher incidence of second tumors in pts showing a shorter time to CRPC [odd ratio (OR) 0.98 (95% CI 0.96-0.99) p = 0.01, and OR 0.99 (95% CI 0.98-1.01) p = 0.09, respectively], whereas no association was reported between CRPC duration and the incidence of immune disorders. Clinical outcome associated with abi/enza in CRPC was independent from pre-treatment presence of immune diseases, but a worse overall survival was observed from diagnosis of prostate cancer in pts developing autoimmune diseases (HR 1.69, 95% CI 1.10-2.61, p = 0.016) .
Conclusions
Time to CRPC may represent a risk factor of developing immune alterations with a negative prognostic role in the overall survival of prostate cancer pts. Further larger prospective studies are warranted.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
V. Conteduca: Advisory / Consultancy, Travel / Accommodation / Expenses: Bayer; Travel / Accommodation / Expenses: Sanofi; Travel / Accommodation / Expenses: Janssen-Cilag; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Astellas. O. Caffo: Advisory / Consultancy, Speaker Bureau / Expert testimony: Janssen-Cilag; Advisory / Consultancy, Speaker Bureau / Expert testimony: Astellas; Advisory / Consultancy, Speaker Bureau / Expert testimony: Bayer; Advisory / Consultancy, Speaker Bureau / Expert testimony: Pfizer; Advisory / Consultancy, Speaker Bureau / Expert testimony: Sanofi; Advisory / Consultancy, Speaker Bureau / Expert testimony: AstraZeneca. E. Zanardi: Advisory / Consultancy: Janssen. G. Procopio: Travel / Accommodation / Expenses: Bayer; Travel / Accommodation / Expenses: Ipsen; Travel / Accommodation / Expenses: Novartis; Travel / Accommodation / Expenses: MSD; Travel / Accommodation / Expenses: Pfizer; Travel / Accommodation / Expenses: BMS. U.F.F. De Giorgi: Advisory / Consultancy, Speaker Bureau / Expert testimony: Janssen; Advisory / Consultancy, Speaker Bureau / Expert testimony: Sanofi; Advisory / Consultancy, Speaker Bureau / Expert testimony: Bayer; Advisory / Consultancy, Speaker Bureau / Expert testimony: Astellas; Advisory / Consultancy, Speaker Bureau / Expert testimony: Janssen; Advisory / Consultancy, Speaker Bureau / Expert testimony: BMS. All other authors have declared no conflicts of interest.
Resources from the same session
4543 - Long-term real-world (RW) outcomes in patients with advanced melanoma (MEL) treated with ipilimumab (IPI) and non-IPI therapies: IMAGE study
Presenter: Stéphane Dalle
Session: Poster Display session 3
Resources:
Abstract
4523 - Prognostic Factors for efficacy of Ipilimumab used after AntiPD1 and/or BRAF+MEK inhibitors in Melanoma Patients: an Italian Melanoma Intergroup study
Presenter: Riccardo Marconcini
Session: Poster Display session 3
Resources:
Abstract
3632 - Rechallenge with combination ipilimumab and anti-PD-1 (IPI+PD1) in metastatic melanoma after acquired resistance to IPI+PD1 immunotherapy
Presenter: Adriana Hepner
Session: Poster Display session 3
Resources:
Abstract
3732 - Clinicopathologic characteristics of immune colitis in melanoma patients treated with combination ipilimumab and anti-PD1 (IPI+PD1) and PD1 monotherapy.
Presenter: Kazi Nahar
Session: Poster Display session 3
Resources:
Abstract
5005 - Real-world outcomes of ipilimumab plus nivolumab for advanced melanoma in the Netherlands
Presenter: Michiel van Zeijl
Session: Poster Display session 3
Resources:
Abstract
5524 - Utilization of Real-World Data to Assess the Effectiveness of Immune Checkpoint Inhibitors (ICIs) in Elderly Patients with Metastatic Melanoma
Presenter: D Scott Ernst
Session: Poster Display session 3
Resources:
Abstract
5884 - Tumor mutational burden and response to PD-1 inhibitors: an analysis of 89 cases of metastatic melanoma.
Presenter: Léa Dousset
Session: Poster Display session 3
Resources:
Abstract
3120 - Increase in S100B and LDH as early outcome predictors for non-responsiveness to anti-PD-1 monotherapy in advanced melanoma.
Presenter: Elisa Rozeman
Session: Poster Display session 3
Resources:
Abstract
2157 - Immune status defined by molecular information layers predicts response to pembrolizumab treatment in advanced melanoma
Presenter: Guillermo Prado-Vázquez
Session: Poster Display session 3
Resources:
Abstract
2553 - Interim analysis of a phase Ib study of cobimetinib plus atezolizumab in patients with advanced BRAFV600 wild type melanoma progressing on prior anti-PD-L1 therapy
Presenter: Shahneen Sandhu
Session: Poster Display session 3
Resources:
Abstract