Author of

• 20039

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  Poster Display Session (ID 63)

  • Event: ELCC 2017
  • Type: Poster Display Session
  • Track:
  • Presentations: 2
  • Moderators:
  • Coordinates: 5/07/2017, 12:30 - 13:00, Hall 1

  • 19871

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    115P - Immune related adverse events (irAE) and disease response with nivolumab in pre-treated advanced non-small cell lung cancer (NSCLC) (ID 428)

    12:30 - 13:00  |  Author(s): I. Nordman
    • Abstract

    Background:
    IrAE with nivolumab are recognised. Incidence in practice and correlation with disease response in NSCLC has not been well characterised.
    
    Methods:
    A retrospective, descriptive analysis was carried out on 40 patients who received nivolumab on a compassionate access program from July 2015 to November 2016. Disease response was assessed by RECIST criteria.
    
    Results:
    The median age of patients was 63 years (range 28-80). 24 patients were female (60%). 17 received nivolumab as second line therapy, 12 as third line, 9 as fourth line, and 2 as fifth line. Best response included partial response (PR) in 15% (n = 6), stable disease (SD) in 40% (n = 16), progressive disease (PD) in 38% (n = 15) and unknown in 8% (n = 3). Treatment is ongoing in 30% (n = 12) (mean 6 months, range 2-18 months). 70% (n = 28) had irAE of any grade. Development of rash (n = 11; 28%) and pruritis (n = 10; 25%) were the most frequent irAE experienced. Grade 3 pruritus, pneumonitis, hepatitis, rash, arthralgia, and fatigue were seen. 2 patients developed grade 3 biopsy proven immune related colitis. Treatment requiring endocrinopathies occurred; hypothyroid (13%; n = 5), hyperthyroid (5%; n = 2) and hypoadrenal (5%; n = 2). Therapy was ceased due to grade 4 rash (n = 1), grade 3 hepatitis (n = 1), progressive neurological symptoms (n = 1) and psychiatric symptoms requiring hospital admission with no prior history of psychiatric illness (n = 1). The psychiatric and neurological symptoms resolved with treatment cessation and both patients have ongoing disease control on observation. A death occurred from suspected immune related hepatitis. Importantly, 5 of 6 patients who had PR developed grade 3 and above irAE. Of 13 patients who received treatment for greater than 3 months with SD, 11 developed irAE (85%). Of 10 patients on treatment for greater than 6 months with disease control (PR or SD); 7 developed grade 3 irAE or treatment requiring endocrinopathies. Of 10 non responders (PD within 3 months) 40% (n = 4) developed irAE; all grade 1. Clinically there appears to be a trend between response and development of irAE.
    
    Conclusions:
    The irAE are in line with published data however are of higher incidence and severity in this case series. There may be a trend of response and development of irAE.
    
    Clinical trial identification:
    not applicable
    
    Legal entity responsible for the study:
    Calvary Mater Newcastle
    
    Funding:
    Study conducted by Calvary Mater Newcastle. Nivolumab received on compassionate access programme from Bristol-Myers Squibb (BMS) however BMS have not been involved in data collection or interpretation.
    
    Disclosure:
    All authors have declared no conflicts of interest.
    
    

  • 19883

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    127P - Prognostic significance of advanced lung cancer inflammation index (ALI) In untreated and treated stage IV non-small cell lung cancer (NSCLC): An Australian cancer centre experience (ID 172)

    12:30 - 13:00  |  Author(s): I. Nordman
    • Abstract

    Background:
    The role of advanced lung cancer inflammation index (ALI) at diagnosis is increasingly explored as an independent prognostic factor of survival in stage IV NSCLC. Post-treatment changes in ALI and the potential impact on survival are not clear in this group of patients. We aimed to evaluate prognostic role of ALI in stage IV NSCLC at diagnosis as well as post treatment.
    
    Methods:
    A retrospective descriptive study was conducted for patients with stage IV NSCLC actively treated at Calvary Mater Newcastle, Australia from 2010 to 2015. Advanced lung cancer inflammation index (ALI = BMI x Albumin/NLR; BMI=Body mass index, NLR=Neutrophil-to-lymphocyte ratio, Albumin=Serum albumin g/dl) values calculated at diagnosis and post first cycle chemotherapy/targeted treatment. Demographic variables summarised and estimates of Kaplan-Meier (KM) survival distribution for overall survival (OS) generated. Extended Cox regression used to derive OS hazard ratios of predictive variables. Project approved by Research Ethics Committee.
    
    Results:
    A total of 279 patients with Stage IV NSCLC were treated during the study time. Baseline ALI was available for 276 patients and post first treatment cycle for 189 patients. The Cox PH model suggested ALI was a prognostic factor for OS, hazard ratio = 0.982 (95% CI: 0.973-0.991). Post first-cycle treatment, individuals with mean baseline ALI, had a hazard ratio = 0.391 (95% CI: 0.211-0.629) that was also increasing multiplicatively as a function of baseline ALI. At baseline, KM estimate suggested median survival was 6.23 months (95% CI: 4.83-9.27) for patients with ALI < 18 compared to 14.70 months (95% CI: 11.63-18.20) for those with ALI > 18. Post first-cycle treatment, not adjusted for baseline, patients with ALI < 18 median survival was 5.23 months (95% CI: 3.27-9.07) compared to 12.67 months (95% CI: 10.47-15.13) for ALI > 18.
    
    Conclusions:
    ALI has a strong association with survival from baseline and post first-cycle treatment adjusted for baseline ALI. High pretreatment and post treatment ALI predicts for a longer survival while low pretreatment and post treatment ALI predicts for a shorter survival.
    
    Clinical trial identification:
    
    
    Legal entity responsible for the study:
    Hunter New England Human Research Ethics Committee
    
    Funding:
    Department of Medical Oncology, Calvary Mater Newcastle, Australia Hunter Medical Research Institute, Australia
    
    Disclosure:
    All authors have declared no conflicts of interest.