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Gabriela Bravo Montenegro
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P21 - Locoregional and Oligometastatic Disease - Treatment of Locally Advanced NSCLC (ID 131)
- Event: WCLC 2020
- Type: Posters
- Track: Locoregional and Oligometastatic Disease
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P21.07 - Immune-Related Adverse Events with Durvalumab Consolidation in a Real-World Cohort of Patients with Non–Small Cell Lung Cancer (NSCLC) (ID 2074)
00:00 - 00:00 | Presenting Author(s): Gabriela Bravo Montenegro
- Abstract
Introduction
In patients with locally advanced, unresectable NSCLC, consolidation therapy with durvalumab prolongs both PFS and OS with a favorable safety profile. Previous studies suggest the incidence of immune-related adverse events (irAEs) in clinical practice is higher than that observed in registrational trials. The objective of this study was to describe the incidence and outcomes of irAEs in a real-world cohort.
Methods
Patients with locally advanced, unresectable NSCLC who received consolidation durvalumab from October 2017 – October 2019 were identified as part of an IRB-approved retrospective chart review. Clinical data were extracted and irAEs were graded using the CTCAE, v4.03.
Results
In this cohort, 72 patients (36 male) were identified with a mean age of 67 years (± 11) with a median follow up of 10 months. During treatment, 43 (60%) patients developed an irAE. Grade 1-2 and 3-4 irAEs were observed in 28 (65%) and 13 (30%) of patients, respectively. Durvalumab was discontinued before completion of treatment in 43 (60%) patients, due to toxicity in 26 (36%) and progressive disease (PD) in 14 (19%) patients. The most common adverse events of any grade were pneumonitis in 17 patients (24%), followed by thyroiditis in 13 (18%), hepatitis in 5 (7%) and dermatitis in 4 (6%). Grade 3-4 and grade 5 pneumonitis occurred in 7 (9.7%) and 2 (2.8%) patients, respectively. Of the patients who developed irAEs, 27(63%) required steroids and 3 required additional immunosuppressive therapies. In patients where durvalumab was discontinued due to IO toxicity, 19 out of 26 patients were re-challenged and toxicity returned in 4 (15%). The mean time to development of an irAE was 6 months and median PFS was 22 months.
Conclusion
This real-world study suggests that the overall incidence of grade 3-4 pneumonitis and the rate of drug discontinuation in clinical practice are higher than that reported in the PACIFIC trial. Further studies are needed to identify factors predicting durvalumab-induced irAEs, particularly pneumonitis.
