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Poster session 21

1481P - Singular immune-related adverse events and efficacy outcomes of immune checkpoint inhibitors in advanced non-small cell lung cancer

Date

21 Oct 2023

Session

Poster session 21

Topics

Tumour Site

Non-Small Cell Lung Cancer

Presenters

Jose Miguel Jurado García

Citation

Annals of Oncology (2023) 34 (suppl_2): S755-S851. 10.1016/S0923-7534(23)01943-9

Authors

J.M. Jurado García1, M. Cobo Dols1, A. Cantero1, V. Gutierrez Calderon1, P. Jiménez Gallego2, E. Perez Ruiz1, M.A. Berciano Guerrero1, A. Montesa Pino1, I. Ramos Garcia1, A. Rueda Dominguez1

Author affiliations

  • 1 Medical Oncology, UGCI Oncol. Regional and Virgen de la Victoria University Hospitals. IBIMA, 29010 - Malaga/ES
  • 2 Medical Oncology, Hospital Universitario Regional de Málaga, 29010 - Malaga/ES

Resources

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Abstract 1481P

Background

ICIs have transformed the treatment of advanced NSCLC patients, no real-world data are available about the immune-related adverse events (irAEs). This retrospective study aimed to assess the safety and effectiveness of PD-1/PD-L1 inhibitors in patients with non-small cell lung cancer (NSCLC) and to analyze the association between singular irAEs and effectiveness.

Methods

This was a retrospective study of the clinical data of patients with NSCLC treated with PD-1/PD-L1 inhibitors as 1a or 2a lines from Marzo 2015 to Marzo 2022 at Hospital Universitario Regional de Málaga. We evaluated association of irAE with efficacy, response and overall survival. Kaplan-Meier and Cox proportional hazard analyses were performed.

Results

A total of 510 patients were included in this analysis. Any grade IrAEs were seen in 307 (60%) patients. Of these (Table), 135 (43,9%) patients had grade 1 toxicities, most commonly cutaneous (96), colitis (54), rheumatologic (46) and hepatitis (42). 112 (36,4%) patients had grade 2 toxicities pneumonitis (47), cutaneous (29), colitis (28). 53 (17,2%) patients had grade 3 toxicities: hepatitis (15), pneumonitis (13), cutaneous (10). 8 (2,6 %) patients had grade 4 toxicities hepatitis (5), pneumonitis (2), DRESS syndrome (1). For patients assessed for efficacy, objective response rate (ORR) to ICI was higher in patients with irAEs [46% vs 14%] p=0,001. In fact, the presence of any irAEs had a significantly improved median OS compared to those without irAEs (19,3 months vs 6,5 p = 0.0001) (Median OS in G1-2 20 months and G 3-4 16,2 months had significally higher OS vs non irAEs 6,1 months; p=0,0001). Singular toxicities that predict greater OS >30 months were (Hepatitis G4, endocrine G1 and cutaneous G2); point out toxicities with deleterious effects (colitis G3 and pneumonitis G4). Multivariable analysis demonstrated that the development of any irAEs was related to a significantly improved OS (HR 0.47, 95% 0.26-0.68, p = 0.0001).

Table: 1481P

Summary of singular toxicities and OS (overall survival) in months

IrAEsN 307 Cutaneous 135 OS Pneumo92 OS Colitis89 OS Hepatitis79 OS Rheuma76 OS Endocrine61 OS Renal40 OS
G1 135 96 28.2 29 18.3 54 21.4 42 18.7 46 28.8 40 37.8 19 21.4
G2 112 29 31.1 47 13.8 28 21.4 17 19 28 20.1 18 28.8 14 28.2
G3 53 10 13.4 13 15.3 7 7.2 15 20.6 2 3.8 3 - 7 7.2
G4 8 - 3 1.9 - 5 40.6 - - -
Non N Ir 203 375 9.0 p=0.0001 418 11.4 p=0.54 421 11.2 p=0.018 431 11.6 p=0.146 434 11.1 p=0.001 449 11.1 p=0.001 470 12.6 p=0.05

Conclusions

This study confirms the feasibility and the safety of ICIs in a large, real-world cohort of patients with NSCLC. The development of irAEs in NSCLC patients treated with immunotherapy may predict better treatment efficacy and overall survival.

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.

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