Abstract 40P
Background
IrAEs require prompt recognition and adequate treatment. Real-world data could help in optimizing clinical management of aNSCLC pts.
Methods
We retrospectively analyzed clinical and pathological data of aNSCLC pts consecutively treated with single-agent ICIs at Veneto Institute of Oncology (IOV) between August 2013 and September 2021. We studied the association of clinical and pathological features with irAEs development by univariate and multivariable logistic regression models.
Results
488 pts received ICIs as first (35%) or further line of treatment (75%). Median number of cycles was 6 (range 1–105). 183 pts (40.8%) developed at least one irAE; the most frequent irAEs were skin-related events (20%) and diarrhea (20%). 83 (45%) pts stopped ICIs due to irAE and 33 (18%) permanently discontinued ICIs, 14 (7.6%) required hospitalization. 90 pts (20%) developed two or more irAEs. At second irAE the rate of pts requiring ICIs interruption, discontinuation or hospitalization were similar. Improved outcome was confirmed in pts experiencing at least one irAE, regardless of line of treatment (HR for median overall survival (mOS) = .308, CI 95% .24-.39, p < .000; HR for median progression-free survival (mPFS) = .280, CI 95% .217-.360, p < .000). Multivariate analysis including clinical and pathologic variables showed low tumor burden (< 2 involved organ sites) as independent factor predicting the risk of irAE (OR = 1.85, CI 95% 1.13-3.04, p = .015). Pts experiencing skin-related events had a significantly longer mPFS and mOS than pts with other irAEs: 22.4 m vs 9.7 m (HR = .515, CI 95% .334-.796, p = .003) and 31.9 m vs 18.5 m (HR = .580, CI 95% .262-.703, p = .034).
Conclusions
In real-world setting, the incidence of irAEs and their positive prognostic value were confirmed. Low tumor burden was associated with higher risk of irAEs. This could represent a starting point for the development of a nomogram capable to predict a global risk of irAEs and improve toxicity management.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.