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Yiqing Huang
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ES30 - What is the Best Treatment Strategy to Target Rare Mutations (ID 241)
- Event: WCLC 2020
- Type: Educational Session
- Track: Targeted Therapy - Clinically Focused
- Presentations: 1
- Moderators:
- Coordinates: 1/31/2021, 16:45 - 17:45, Scientific Program Auditorium
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ES30.02 - Chair (ID 4093)
16:45 - 17:45 | Presenting Author(s): Yiqing Huang
- Abstract
Abstract not provided
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P75 - Immunotherapy (Phase II/III Trials) - Misc. Topics (ID 248)
- Event: WCLC 2020
- Type: Posters
- Track: Immunotherapy (Phase II/III Trials)
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P75.10 - Risk Factors for Immune-Related Adverse Events from Anti-PD-1/PD-L1 Treatment in an Asian Cohort of NSCLC Patients (ID 1724)
00:00 - 00:00 | Presenting Author(s): Yiqing Huang
- Abstract
Introduction
Immune-related adverse events (IrAEs) from use of immune checkpoint inhibitors (ICIs) can be serious and unpredictable. Studies have shown that up to 70% of patients receiving anti PD-1/PD-L1 inhibitors experience IrAE (1), of which less than 10% are grade 3 (G3) and above in severity (2). We examine the incidence rate and risk factors for IrAEs in an Asian cohort of NSCLC patients treated with immunotherapy.
Methods
By retrospective review, between June 2014 to Dec 2019, we analyzed IrAEs in patients treated with Anti-PD-1 or Anti-PD-L1 inhibitors for NSCLC at the National University Cancer Institute Singapore. Poisson regression model was used to estimate the effect of risk factors on the incidence rate of any grade IrAEs.
Results
One hundred and twenty-four patients were enrolled, contributing 1238 person-months. Median age was 63.5 years (range 57-71). Majority were males (71%), Chinese (74%), with ECOG PS of 0-1 (80%). Sixty-one percent were smokers. Fifty-eight percent received Pembrolizumab, followed by Nivolumab (14%), Durvalumab (14%) and Atezolizumab (11%), respectively. Most (72%) received immunotherapy in the 1stor 2ndline setting. The median number of cycles was 3 (2-6), and median duration of treatment was 2.0 months (0.87-4.82). Median duration of follow-up was 6.9 months.
IrAEs were seen in 57 patients (46%), with fatigue (45%), pneumonitis (9.9%) and rash (8%) being the most common. The incidence rate of any grade IrAE was 91 cases per 1000 person-months. Of note, 14% had grade 3 or higher IrAE: the most common of which were pneumonitis (38.9%), fatigue (27.8%) and transaminitis (11.1%). One patient each had G3 neuropathy, G4 toxic epidermal necrolysis and G3 cardiomyopathy respectively.
On univariable analysis, age >/=75, body mass index (BMI)>/=25, use of concomitant chemotherapy with ICIs and smokers were associated with increased incidence rate of IrAEs (Incidence Rate Ratio (IRR) 1.446, p=0.099; IRR 1.05, p=0.032; IRR 1.667, p=0.011; IRR 1.505, p=0.022). Pembrolizumab had higher risk of IrAEs compared to other ICIs (IRR 1.535, p=0.023).
Multivariable analysis demonstrated that age, BMI>/=25, use of concomitant chemotherapy and use of pembrolizumab remained as strong predictors for IrAEs (p=0.040; p=0.011; p=0,002; p=0.006).
Conclusion
The incidence rate of any grade IrAEs was 91 cases per 1000 person-months. Patients who were 75 years and older, obese, used concurrent chemotherapy with anti-PD-1/PD-L1 agents, or received pembrolizumab had higher incidence rates of IrAEs. Our findings can help guide risk stratification and monitoring of IrAEs among NSCLC patients on immunotherapy. Future studies are needed to validate our results.
References:
1) Michot, J.M., Bigenwald, C., Champiat, S. et al. Immune-related adverse events with immune checkpoint blockade: a comprehensive review. Eur J Cancer. 2016; 54: 139–148
2) Wang PF, Chen Y, Song SYet al. Immune-Related Adverse Events Associated with Anti-PD-1/PD-L1 Treatment for Malignancies: A Meta-Analysis. Front Pharmacol. 2017 Oct 18;8:730
