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Mike Nguyen



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    P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.16-31 - Immunotherapy in the Regional Setting: Real World Experience of Outcome and Toxicity (ID 335)

      10:15 - 18:15  |  Presenting Author(s): Mike Nguyen

      • Abstract

      Background

      Immune checkpoint inhibitors (ICI) have revolutionised the management of lung cancer. These agents have an established role in metastatic non small cell lung cancer (NSCLC) and inoperable NSCLC. Recent studies demonstrate benefit of ICI in first line treatment of metastatic NSCLC. Ongoing studies are exploring the role of ICI in early stage lung cancer and small cell lung cancer. ICI possess a distinct adverse effect profile which differs from cytotoxic chemotherapy. We explore the implications of ICI for patients with NSCLC in a regional setting.

      Method

      The medical records of all patients with NSCLC who were treated with an immune checkpoint inhibitor at our cancer centre were examined. Information regarding patient demographics, tumour histology, PDL1 staining, performance status, smoking status and sites of metastasis were obtained. We calculated rates of clinical outcomes including progression free survival and objective response rates. We also examined rates of adverse effects and need for emergency department presentation, hospitalisation and treatment with steroids.

      Result

      Forty-five patients with lung cancer who were treated with ICI between 2016 and 2018 were identified. 70% were male. The average age was 70 years. 30 (67%) received nivolumab, 8 (18%) received atezolizumab, 4 (9%) received durvalumab and 3 (6%) received pembrolizumab. 31 (69%) had adenocarcinoma histology. Only 4 patients (9%) had PDL1 stain testing performed; 3 were PDL1 high (greater than 50%) and 1 was PDL1 negative. 13% of patients had brain metastases and 16% had liver metastases. Of the 41 patients with metastatic disease, 10 patients obtained a partial response. The objective response rate was 22%. Median progression free survival was 5.8 months. Median overall survival was 11.6 months. 37 patients (82%) had an adverse effect of any grade and 7 (16%) had a grade 3 or greater adverse effect. The most common adverse effect was fatigue (62% any grade, 6% grade 3 or greater). 36% of patients required steroid treatment. 12 patients (27%) died within 30 days of receiving ICI.

      Conclusion

      Treatment of cancer patients in regional settings carry unique challenges which need to be overcome in order to ensure equitable health outcomes. We report the experience of an individual regional cancer centre. Results are comparable to other published reports and demonstrate safe treatment of lung cancer patients in a regional setting.