Abstract 193P
Background
Immune checkpoint inhibitors (ICIs) are associated with immune-related adverse events. Rechallenge after a first episode of ILD remains controversial.
Methods
We conducted a multicenter retrospective cohort study of ICIs rechallenge after a first episode of an ICI-associated with interstitial lung disease (ICI-ILD). The objective was to evaluate the safety and efficacy of immunotherapy rechallenge.
Results
Thirty-two patients were included and were initially treated with anti-PD-1 monotherapy (84.4%) or in combination with anti-CTLA-4 (15.6%) and experienced grade 1 (25%), grade 2 (56.2%) grade 3 (18,8%) ICI-ILD. Most patients (90.6%) were rechallenged with anti-PD-1 monotherapy. Thirteen patients (40.6%) experienced ILD recurrence following rechallenge. Median time to recurrence of ICI-ILD after ICI rechallenge was shorter for the recurrence vs for the first episode: 0.9 (range: 0.2-8.3) vs 3.0 (0.03-35.7) months. The second episode of ICI-ILD appeared to be more severe than the first one, regarding both symptoms (38.5% vs 18.8 % of grade ≥ 3 ILD), and radiological features (higher number of lobes and intensity of CT-scan lesions after centralized review). One ICI-ILD related death was reported. 53.8% of patients recurred with a similar radiological pattern. Steroids use during rechallenge was not associated with ICI-ILD recurrence risk. Objective response rate and disease stabilization under ICI rechallenge were at 18.8% and 34.4%. Progression free survival and overall survival were not statistically different in patients who experienced ICI-ILD recurrence vs not. Three months after the rechallenge, 15 patients (46.9%) had progressive disease: 55.6% in the recurrence group and 43.6% in the no recurrence group.
Conclusions
40.6% of patients had a recurrence of ICI-ILD after rechallenge with ICI. The second episode of ICI-ILD appears to have similar radiological patterns but to be more severe and to occur earlier than the first one.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.