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E. Kotteas
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Poster Display session (Friday) (ID 65)
- Event: ELCC 2018
- Type: Poster Display session
- Track:
- Presentations: 2
- Moderators:
- Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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186P - Thyroid toxicity as an immune-related adverse event in patients with non-small cell lung cancer during treatment with immune checkpoint inhibitors (ID 364)
12:30 - 13:00 | Author(s): E. Kotteas
- Abstract
Background:
Programmed cell death protein 1(PD-1)/programmed death-ligand 1(PD-L1) inhibitors have improved outcomes for cancer patients, in exchange for novel immune-related adverse events (irAEs), including thyroid toxicity that is documented in up to 10% of cases.
Methods:
The medical records of 42 patients with stage IV non-small cell lung cancer (NSCLC), treated with anti-PD-1/PD-L1 monoclonal antibodies, were retrospectively evaluated. Thyroid function tests (TFTs) were assessed both at baseline and at regular 6-week intervals. Demographics and clinicopathological features of patients and frequency, grade, clinical course and management of thyroid toxicity were recorded and analyzed.
Results:
Thyroid toxicity was observed in 12 cases (28.6%). 6 patients developed hyperthyroidism, which was only transient in 4 of them (66.7%), before advancing to hypothyroidism. De novo hypothyroidism ensued in 2 patients. The remaining 4 patients were hypothyroid, receiving hormone replacement therapy at baseline and needed dose adjustment due to thyroid toxicity. Median time on treatment until development of thyroid toxicity was 47 days (range from 15 to 251 days). Grade I events were recorded in 6 patients (50%), grade II in 5 (41.7%) and only one patient (8.3%) experienced grade III thyroid toxicity. Oral levothyroxine was prescribed for symptomatic hypothyroidism. B-blockers in combination with low doses of oral methylprednisolone (a maximum of 16 mg per day) were administered in symptomatic hyperthyroid patients. TFTS became normal in 11 patients; 4 individuals needed long-lasting hormone replacement. None of our patients had to permanently discontinue anti-cancer immunotherapy.
Conclusions:
A relatively high rate of immune-mediated thyroid toxicity was observed in our cohort. Low doses of oral methylprednisolone were effective in controlling clinical hyperthyroidism, while grade III/IV thyroid toxicity was rare. Further studies are warranted to explore the possibility of an increased susceptibility to immune-mediated thyroid-related adverse events in the Greek population, and the factors underlying this phenomenon.
Clinical trial identification:
Legal entity responsible for the study:
University of Athens
Funding:
Has not received any funding
Disclosure:
All authors have declared no conflicts of interest.
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229P - Clinical and laboratory markers of prognosis in lung cancer patients with hypercalcemia (ID 329)
12:30 - 13:00 | Author(s): E. Kotteas
- Abstract
Background:
Hypercalcemia is a severe complication in lung cancer patients, imposing prompt recognition, investigation and treatment. The primary aim of our study was to further investigate the clinical and laboratory prognostic features in a cohort of lung cancer patients with hypercalcemia.
Methods:
The medical records of a total of 100 sequential, non-selected, patients with histologically or cytologically-confirmed diagnosis of small or non-small cell lung cancer (SCLC/NSCLC) and hypercalcemia, diagnosed and treated at the Oncology Unit of Sotiria Athens General Hospital between December 2015 to April 2016 were retrospectively reviewed. Demographic, clinical and laboratory patients’ characteristics were correlated with outcome data.
Results:
Mean age (±SD) of our patient population at the diagnosis of hypercalcemia was 64.3 (±8,8) years; male to female ratio was 86/14. The albumin-corrected calcium was 11.0 ± 0.6 mg/dl (range 10.5–13.9). The majority of patients had non-small cell lung cancer (89%), mainly of squamous type (48.3%) and adenocarcinoma (43.8%), and stage IV disease (57%). Development of bone metastases (BMs) was observed in 17.7% of patients, while 5% of patients had received bisphosphonates. Hypercalcemia-leukocytosis syndrome was associated with advanced stage (p = 0.001) and the presence of bone metastases (p < 0.05). Median time to progression was 3.5 months (interquartile range: 1.2–7.2) and median overall survival (mOS) was 13.8 months (95% CI: 7.3–20.2). In univariate Cox proportional hazard models, patients with lower serum albumin levels (p < 0.001), concomitant presence of leukocytosis (p < 0.05), advanced disease stage (p < 0.01) and negative history of resected disease (p < 0.001) had higher risk of death. In multivariate Cox regression analysis, serum albumin (HR 0.37, 95% CI 0.16–0.86; p < 0.05), metastatic disease (HR 1.92, 95% CI 1.01–3.68; p < 0.05) and the history of surgical resection (HR 0.25, 95%CI 0.10–0.61; p < 0.01) were independent predictors of survival.
Conclusions:
Our study results, derived from a combined cohort of SCLC and NSCLC patients with hypercalcemia, suggest that serum albumin levels may provide independent prognostic information in this setting.
Clinical trial identification:
Legal entity responsible for the study:
University of Athens
Funding:
Has not received any funding
Disclosure:
All authors have declared no conflicts of interest.
