Abstract 976P
Background
The aim of this study is to determine the causes of death in patients who received at least one dose of immunotherapy and died within 30 days after the first dose of immunotherapy regardless of the purpose of treatment and cancer type. The second aim of the study is to evaluate the characteristics of the disease and patients before starting immunotherapy and to determine the prophylactic features to be taken to reduce the complications of immunotherapy.
Methods
The data of a total of 1432 patients treated with immunotherapy in six tertiary referral hospital were retrospectively analyzed.
Results
It was determined that 34 (2%) of the patients died within 30 days following the first dose of immunotherapy. Approximately half of the patients (55%) had good performance at the beginning of immunotherapy (ECOG 0-1), again half of the patients had no comorbidity. Death occurred in all patients who received palliative therapy, and most patients (88%) received immunotherapy as second or subsequent line of therapy. The most common diagnosis of death patients were malignant melanoma (40%), lung cancer (24%) and renal cell carcinoma (20%) and other (16%). Twenty-three patients died in the hospital, the most common cause of death was disease progression and thromboembolic events (Table). Table: 976P
Information on death occurred in the first 30 days after immunotherapy
| All patients | |||
| N=34 | (%) | ||
| Median time from immunotherapy to death (min-max) (days) | 26 | (2-30) | |
| Immunotherapy-related immune side effect | |||
| Autoimmune nephritis | 2 | (6%) | |
| Autoimmune hepatitis | 1 | (3%) | |
| Myocarditis | 1 | (3%) | |
| Adrenal insufficiency | 1 | (3%) | |
| Myastenia gravis | 1 | (3%) | |
| None | 28 | (82%) | |
| Hyperprogression | |||
| Yes | 3 | (10%) | |
| No | 31 | (90%) | |
| Death place | |||
| Hospital | 23 | (66%) | |
| Home | 9 | (28%) | |
| Nursing home | 2 | (6%) | |
| Cause of death | |||
| Disease progression | 7 | (40%) | |
| Sepsis | 5 | (15%) | |
| Pulmonary embolism | 4 | (12%) | |
| Immune side effect | 3 | (9%) | |
| Myocardial infarction | 3 | (9%) | |
| Gastrointestinal system bleeding | 1 | (3%) | |
| Unknown | 11 | (32%) |
Conclusions
The relationship between first 30-day mortality and disease progression/thromboembolic events has been demonstrated in patients using immunotherapy in the treatment of metastatic cancer.
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.