Abstract 1159P
Background
Immune checkpoint inhibitors (ICIs) had become standard therapy in the management of advanced non-small cell lung cancer (NSCLC). Despite the improvements in survival, ICIs have unique immune-related adverse events (irAEs), which resembles autoimmune diseases. Endocinopathies (EPs) are frequently reported in the clinical trials, but their proportion and effects on the treatments are still obscure. We analyzed real world data of ICI related EPs in metastatic NSCLC patients and their effects on the prognosis and survival.
Methods
We retrospectively collected the patients’ data, who diagnosed as recurred or metastatic NSCLC and received ICI therapy. From the data, we investigated the incidence and treatment data of ICI related EPs and consulted to an endocrinologist for the accurate diagnosis. We also collected the survival and safety data.
Results
From JAN-2012 to FEB-2022, 218 patients with recurrent, metastatic NSCLC patients received ICI treatments. The types of ICI that patients were received were PD-1 inhibitors 137 (62.8%), PD-L1 inihibitors 68 (31.2%), CTLA-4 inhibitor or its’ combination 5 (2.3%), and other ICI combination were 8 (3.7%). EPs were occurred in 18 (8.3%) patients. Two (0.9%) patients present with multiple EPs simultaneous or sequentially. Most frequent EP was hypothyroidism (8, 44.4% of EP) followed by hyperthyroidism (33.3%), adrenal insufficiency (22.2%) and type 1 diabetes (11.1%). None of the patients discontinued the ICI treatment because of EP. Progression free survival (PFS) and objective response rate was slightly higher in the EP group than in the non-EP gorup, but not conclusive due to the small number of EP patients.
Conclusions
From the current study, we collected the real-world data of EP related to ICI therapy in metastatic NSCLC patients. The incidence of EP was slightly lower than in the previous reports, reflecting the lack of routine hormone lab test in asymptomatic patients out-of trial setting in clinic. All the EP cases were manageable by consulting to endocrinology specialists, and none of them discontinued the ICI treatment from EPs. Effect of EPs on the survival were not conclusive in this analysis but patients with EP showed higher response rates and PFS.
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.