Abstract 1331P
Background
The use of immune-checkpoint inhibitors (ICI) is associated with the development of new immune-related adverse effects (irAEs) in some patients. Our aim was to study if there is any correlation between the development and grade of irAEs and the efficacy of ICI.
Methods
We collected data of 138 patients (83% male) diagnosed of advanced NSCLC and treated with ICI between December 2015 and March 2020 in our institutions. The median age was 66 years (range 48-85). Fifty-nine percent had adenocarcinoma histology, 40% squamous. Six percent had stage III-B at the start of immunotherapy, 35.5% stage IVa, 26.8% IVb and 31.2% IVc. Fifty percent of the patients had unknown or negative PDL1, 16.7% had expression in 1-49% of tumor cells and 32.6% expression of more than 50%. Twenty-three percent received immunotherapy at 1st line and 76.8% in 2nd or later. Several variables as clinical, tumour-related and therapeutical were included and univariate and multivariate Cox regression analysis were performed.
Results
irAEs occured in 49% of patients; 12% developed grade 3 to 4 toxicities. More frequent irAEs were fatigue (24%), rash (16%) and arthralgias (15%). The appearance of any grade of toxicity was associated with improved progression-free survival (PFS) (median 18.07 months vs 4.97 months; HR 12.81; p < 0.001). Patients who developed grade 3 or worse irAEs had longer PFS than those who develop grade 1 or 2 irAEs and those who did not suffered any irAEs (27.23 vs. 16.60 vs. 4.87 months; HR 7.02; p < 0.001). The use of corticosteroids during treatment with ICI was not related to PFS.
Conclusions
Development of serious irAEs during treatment with ICI was associated with better outcomes in our population. The use of corticosteroids during immunotherapy did not affect the efficacy of treatment.
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.