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Wilma Hopman



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    P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.01-04 - Immune Checkpoint Inhibitors (ICIs) in NSCLC: Immune Related Adverse Events (irAEs) and Outcomes. A Canadian Single Institution Experience. (ID 12522)

      12:00 - 13:30  |  Author(s): Wilma Hopman

      • Abstract
      • Slides

      Background

      The ICIs are a major therapeutic advance in NSCLC with recognized toxicity in the form of irAEs. The association between irAEs and clinical benefit remains unclear but promising. The aim of this study was to examine the incidence and nature of of irAEs and correlative outcomes in patients treated with ICIs for advanced/recurrent NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A retrospective chart review of all advanced NSCLC patients treated with immunotherapy between January 2015 to December 2016 was undertaken. Treatment was either on a clinical trial or as a standard of care. Patient demographics, clinical, pathological, and radiological parameters were assessed and an exploratory analysis was conducted to review these factors and outcomes in patients with and without irAEs. The nature and timing of the irAES was also evaluated.

      4c3880bb027f159e801041b1021e88e8 Result

      47 patients had ICIs: 24 (51%) received either Nivolumab, Pembrolizumab or Durvalumab alone (SAIO), 15 (32%) had dual agent immunotherapy (DAIO), 8 (17%) had chemotherapy plus ICI. 26 pts (55.3%) were female; median age was 65 years (range 50-90), 15 (31%) had squamous NSCLC. Median months (m) of ICI treatment were 5 (1 – 32). 21/47 (45%) were alive at 1 year. IrAEs occurred in 29 patients (61.7%), 13% SAIO, 23% DAIOs and 15% chemotherapy plus ICI. IrAEs were: dermatological (n=13), diarrhea/colitis (n=10/1), thyroid dysfunction (n=9), and pneumonitis (n=8), hypophysitis (n=1) and nephritis (n=1). The earliest irAE was dermatological with a median onset of 6 weeks. In those with irAEs versus (v) no irAEs: RR = 55% v 11%, disease control rate (DCR) 76% v 33%. 13/29 (45%) had an irAE in ≤ 6 weeks: RR = 38%, DCR = 53% and 6 of these (46%) were alive at 1 year. 21 patients were alive at 1 year: 16/21 (76%) had an irAE and of these, 13/16 (81%) had 2 irAES or irAEs ≥ grade (G) 2. Median overall survival (OS) for all patients was 9m (6.3-11.7). Landmark analysis at 3m: median OS for no irAES v irAEs was 15m v 18 m, log rank p=0.76. Median survival of those with no irAE v G1 v ≥ G2 was 2m v 8m v 23m, log rank p= 0.014. Further correlative outcome data will be presented.

      8eea62084ca7e541d918e823422bd82e Conclusion

      A landmark analysis at 3m did not show a statistically significant correlation between irAEs and survival. This merits further study as does the suggestion of a correlation between number of irAEs and grade with regards to outcome.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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