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Javier Castillo



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    P1.04 - Immunooncology (Not CME Accredited Session) (ID 936)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.04-27 - Safety of Immunotherapy in Non-Small Cell Lung Cancer (NSCLC) in the Real-Life Setting: A Single-Institution Experience from Argentina. (ID 13553)

      16:45 - 18:00  |  Author(s): Javier Castillo

      • Abstract
      • Slides

      Background

      Immunotherapy (IO) targeting programmed death-1 receptor (PD-1) has become standard of care in NSCLC treatment. Therefore, many patients will be at risk of developing toxicities from these treatments, representing a new challenge in daily clinical practice. We assessed its safety and activity in advanced NSCLC patients in the real-life setting.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We conducted a retrospective analysis of patients with NSCLC treated with immunotherapy at a single institution between January 2016 and January 2018. Safety and efficacy analyses were made by treating physician according to CTCEAE 4.0 and RECIST 1.1 respectively and retrospectively collected from medical records. Kaplan-Meier method was used to estimate progression-free survival (PFS) and overall survival (OS).

      4c3880bb027f159e801041b1021e88e8 Result

      Twenty-seven patients were included. Median age was 66 years [range 45 - 79], 67% were male, 89% (n=24) had ECOG performance status (PS) of 0-1; all patients had advanced disease, with up to 2 metastatic sites in 52% (n=14) of the cases; 45% (n=12) had been tested and were positive for PDL-1 (≥ 1%). Almost all patients received immunotherapy as first or second-line treatment (n= 23, 85%). A median of 6 cycles [range 1 – 34] had been administered, with 60% exposed to nivolumab (n=16) and 40% (n=11) to pembrolizumab. Median follow-up since IO was 18 months [range 0.5 - 25.2]. Seven patients achieved partial response and eight had stable disease, giving an overall response rate of 26% and a 56% disease control rate; 44% presented progressive disease. Median PFS was 5.1 months [95%CI 2 – 8.1] and median OS was 19.3 months [95%CI 2.3 – 36.3]. A total of 10 patients (37%) developed high grade toxicity. The most common grade 3-4 related events were asthenia (n=5), adrenal insufficiency (n=2), infection (n=2), hypothyroidism (n=1), hepatitis (n=1), renal insufficiency (n=1) and thrombocytopenia (n=1) among others. Seven patients should discontinue treatment, 5 of them received glucocorticoids and almost all of them had full recovered after corticoid treatment (n=5).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Activity of immunotherapy was comparable to that reported in previous studies. However, high grade toxicity rates in our practice were much higher than those reported in clinical trials, despite the highly similar proportion of patients with good performance status in both settings. Although studies populations are highly selected, this finding must lead us to question our ability in early recognition and prompt management of adverse events in daily practice.

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