Abstract 1067P
Background
The emergence of cardiotoxicity during immunotherapy has been considered as being responsible for more than 50% of the mortality related to these therapies. However, the related mortality due to the underestimation of heart disease among immunotherapy treated cancers is still under debate.
Methods
According to the date of approval for use in these indications, cases of the major cancers treated with immune- dependent therapy with a cardiac cause of death were selected. Non- small cell lung cancer (NSCLC), melanoma, and prostate cancer were searched for in the SEER database in the periods of 2007 vs. 2015, 2004 -2010 vs. 2011-2014, and 2004-2009 vs.2010-2014, respectively. Chi-square, Kaplan –Meier method, and Cox proportional hazard model analysis was used for multivariate analysis.
Results
Results showed that among the 538 advanced NSCLC, 111 advanced melanoma, and 640 advanced prostate cancer cases, those dominated by men and people aged more than 70 years had a high percentage of heart disease-related death in both eras of advanced NSCLC and melanoma immunotherapies. By Chi square test, the difference between the groups was non-significant (P = > 0.05) except for variables of prostate cancer group (age, race, marital status, grade; P = < 0.05). Difference in OS (overall survival) of all-cause mortality showed better survival for all cancers treated with immunotherapy (P = 0.0001). In cardiac-related deaths, negative survival was only observed in the immunotherapy era of NSCLC (P = 0.0001) and not in comparative groups of either melanoma or prostate cancer. In the NSCLC- based immunotherapy group, both monotherapies of chemotherapy and radiation exhibit better survival (P = 0.0001, 0.001) and the use of combined treatments did not result in a difference in survival for patients (P = 0.392). In multivariate analysis of NSCLC with immune - based treatment, the non- squamous histology appears to be an independent risk factor for lower survival compared to squamous cell type (P = 0.04; HR= 0.74; CI = 0, 55- 0.99).
Conclusions
Although immunotherapy provided a significant increase in OS compared with the non-usage of most immunotherapy plans, a decrease in OS was observed in patients with NSCLC who died from heart diseases. Thus, patients with NSCLC should be highly monitored during immunotherapy, especially those with a history of cardiac dysfunctions.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.