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Meghan J Mooradian



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    P2.04 - Immunooncology (Not CME Accredited Session) (ID 953)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.04-23 - Immune-Related Adverse Events: The Growing Pains of Immunooncology (ID 14076)

      16:45 - 18:00  |  Presenting Author(s): Meghan J Mooradian

      • Abstract

      Background

      Immune checkpoint inhibitors (ICI) are associated with a distinct spectrum of toxicities, generally characterized as immune-related adverse events (irAEs). Despite increased recognition and improved management (mgmt), life-threatening toxicity affects a subset of pts. The Massachusetts General Hospital has created a novel inpatient oncology service, the severe ICI toxicity service (SIC), which aims to refine treatment of these irAEs.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively identified pts with advanced thoracic malignancies who had received standard ICI (anti-PD(L)-1+/-CTLA-4 inhibition) and had been hospitalized for a grade ≥3 irAE. Demographic and clinical data were extracted from the medical chart and a descriptive analysis was performed.

      4c3880bb027f159e801041b1021e88e8 Result

      We identified 32 pts who required admission for toxicity mgmt. (Table 1). Average age on admission was 67yo (53-86) with an equal distribution between genders. Toxicity onset occurred at 101days (2-579) after the 1st ICI dose with 93.5% receiving anti-PD-(L)1 monotherapy. The most common irAEs were pneumonitis (35%), hepatitis (22%) and colitis (19%). 84% of pts received high-dose corticosteroids (1mg/kg) with 15% requiring a 2L immunosuppressant. In pts who completed a steroid taper, duration of use was 81d (42-192). The average length of stay was 8d (2-24) with 7pts requiring re-admission for toxicity flare. Eight pts (25%) experienced a grade 5 event (6 pneumonitis, 1 myocarditis, 1 hepatitis). Median PFS and OS were 6.3mths and 8.2mths, respectively.

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      8eea62084ca7e541d918e823422bd82e Conclusion

      Severe irAEs requiring inpatient admission, though infrequent, result in considerable morbidity and mortality. Improved understanding of these toxicities and the mechanisms underlying their development is crucial. Novel academic efforts, such as the SIC service, are needed to fully characterize irAEs and ultimately develop novel therapeutic strategies to manage them.

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