Author of

• 36267

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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

  • 36293

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    P75.19 - Investigation of Lung Cancer Patients Receiving Immunotherapy with Pre-Existing Lung Disease (ID 2471)

    00:00 - 00:00  |  Presenting Author(s): Kerri McGovern
    • Abstract
    • Slides

    Introduction
    

    Today, lung cancer treatment is tailored to the individual patient with attention to clinicopathological characteristics and co-morbidities. With the expanding role of checkpoint immunotherapy (CPI), it is important to evaluate pre-existing conditions that might increase the risk of immune-related adverse events. Given the incidence of pneumonitis from CPI is between 3 to 5% in randomized controlled trials, poor baseline pulmonary reserve raises concern for respiratory compromise if these patients were to develop immune-related pneumonitis. Interstitial lung disease (ILD), specifically, can be an autoimmune phenomenon which could potentially increase this risk. We report our investigation into outcomes of lung cancer patients with underlying chronic obstructive pulmonary disease (COPD) or ILD treated between 2015 and 2019 using retrospective data at our institution.

    Methods
    

    Data collected included age, COPD or ILD, duration of response, and rates of pneumonitis. The diagnosis of COPD or ILD was defined based on pulmonology evaluation and/or pulmonary function tests. Patients with small cell lung cancer were excluded. Duration of response was measured from date of initiation of immunotherapy to documented progression of disease or death

    Results
    

    We identified 164 patients with non-small cell lung cancer (NSCLC) (median age: 71; range: 30 – 93) who received CPI. Among them, 57 had pre-existing COPD and 3 had ILD. The median duration of response to immunotherapy in those with COPD or ILD was 5 months and also 5 months in those without COPD or ILD. In terms of adverse events, pre-existing COPD or ILD seemed to be associated with higher rates of pneumonitis. Pneumonitis occurred in 5 of 60 (8.3%) in the COPD or ILD group compared to 6 of 104 (5.8%) (P = 0.5) in those without COPD or ILD. None of the patients with ILD experienced pneumonitis.

    Conclusion
    

    Patients diagnosed with NSCLC often have pre-existing conditions including COPD and ILD. Our study shows that despite these co-morbidities, duration of response to CPI is similar to that of patients without these conditions. Our data does, however, suggests a potential increased risk of pulmonary treatment-related complications, more specifically pneumonitis.

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