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Ya Zeng
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EP1.04 - Immuno-oncology (ID 194)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.04-28 - The Abscopal Effects of the Combination of Radiotherapy and GM-CSF for Patients with Metastatic Thoracic Cancers (Now Available) (ID 1097)
08:00 - 18:00 | Author(s): Ya Zeng
- Abstract
Background
An absopal response was defined as distal tumor regression out of irradiated field induced by radiotherapy and mediated by immune system. Golden EB et al reported a benefit with the use of Granulocyte-macrophage colony-stimulating factor (GM-CSF) with local radiotherapy in a subset of chemotherapy or hormone therapy in patients with metastatic solid tumors. However, the contribution of systemic therapy to abscopal effects couldn’t be defined. Therefore, we conducted the study aiming to evaluate the abscopal effects of the pure combination of local radiotherapy and GM-CSF in patients with metastatic thoracic cancers.
Method
Patients who met the following criteria were included for this study: (1) Pathologic confirmation of thoracic cancer by histology; (2) at least three distinct measurable sites of metastatic disease; (3) received at least one line of previous chemotherapy and had stable or progressing disease to the last chemotherapy or refused to receive chemotherapy; (4) received the combination of GM-CSF and radiotherapy; (5) no previous malignancies; (6) no previous immunotherapy.
Result
A total of 30 consecutive patients who were treated between March 31, 2016 and March 31, 2019 were included in this study. In the 16 patients with lung cancer, 2 partial abscopal responses, 9 stable and 5 progress were observed. In the 10 patients with thymic cancer or thymoma, 2 partial abscopal responses (thymic cancer), 6 stable and 2 progress were seen. Neither of the two patients with esophageal cancer had progressive diseases within 3 months. The patient with tracheal adenoid cystic carcinoma had partial response to the treatment, whereas the other patient with malignant pleural mesothelioma had stable disease. Twenty-four patients (80%) received GM-CSF of 125ug/m2 d8-22, which was the same as Golden EB et al reported. However, 8 patients had high fever (33.3%), 4 patients (16.7%) had edema (Grade 2: 3, Grade 3: 1), 4 patients (16.7%) had dyspnea of Grade 2, and one patient had dermatitis of Grade 3. Another one patient underwent cerebral infarction during the third day of GM-CSF injection. The other 6 patients who had GM-CSF of 70% dosage (87.5ug/m2) had no obvious side effects. No evidence showed that the reduced dosage of GM-CSF may have negative influence on the effect of the treatment.
Conclusion
In conclusion, pure combination of local radiotherapy and GM-CSF may increase the incidence of abscopal responses, and bring benefits to patients with thoracic cancers except esophageal cancer. Lower dosage of GM-CSF is recommended to Asian patients.
