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71P Correlation between toxicities and outcomes during treatment with immune checkpoint inhibitors in non-small cell lung cancer patients
Annals of Oncology ( IF 50.5 ) Pub Date : 2019-12-15 , DOI: 10.1093/annonc/mdz449.025 P. Ayala de Miguel , S. Arnáiz Díez , I. Gorospe García , J. López Gallego , A. Illán Varella , P. Borrega García
中文翻译:
71P非小细胞肺癌患者使用免疫检查点抑制剂治疗期间毒性与预后的相关性
更新日期:2020-04-17
Annals of Oncology ( IF 50.5 ) Pub Date : 2019-12-15 , DOI: 10.1093/annonc/mdz449.025 P. Ayala de Miguel , S. Arnáiz Díez , I. Gorospe García , J. López Gallego , A. Illán Varella , P. Borrega García
Abstract
Background
Immunotherapy of cancer has changed the paradigm of treatment of many tumours, especially non-small cell lung cancer (NSCLC). The use of immune-checkpoint inhibitors (ICI) is associated in some patients with the development of new immune-related adverse effects (ir-AEs). Our aim was to study if there is any correlation between the appearence of ir-AEs and the efficacy of ICI.Methods
We collected data of 66 patients diagnosed of advanced NSCLC and treated with ICI in monotherapy at our institution between December 2015 and May 2019. Several variables as clinical, tumour-related and therapeutical were included and univariate and multivariate Cox regression analysis were performed.Results
Cohort of 50 men and 16 women, median age of 67 years and 80% with Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1. 66% were active or ex-smokers and 34% had never smoked. 62% of patients had adenocarcinoma histology, 32% scamous and 3% had not otherwise specified (NOS) carcinoma histology. 3% of patients had III-B stage at the moment of start of immunotherapy, 36% M1a, 35% M1b and 24% M1c. 2 patients had driver mutations in EGFR gene. 53% of patients had unknown PDL1 status; 9% had no PDL1 expression, 9% low expression and 27% high expression. 82% of patients had progressed to prior line of treatment, while 18% were treatment-naive. irAEs occured in 55% of patients; 11% developed grade 3 to 4 toxicities. More frequent irAEs were fatigue (61%) and rash (32%). Significant statistical variables in univariate analysis were included in multivariate analysis by Cox regression. The appearence of any grade of toxicity was associated with improved progression-free survival (PFS) (median 5.2 months vs 2.7 months; HR 3.53; p = 0.018; 95% CI [1.24-10.07] ). The use of corticosteroids during treatment with ICI was not related to PFS.Conclusion
Appearance of immune-related adverse effects during treatment with ICI was associated with better outcomes in our population. The use of corticosteroids during immunotherapy didńt have any deleterious effect on the efficacy of treatment.Legal entity responsible for the study
The authors.Funding
Has not received any funding.Disclosure
All authors have declared no conflicts of interest.
中文翻译:
71P非小细胞肺癌患者使用免疫检查点抑制剂治疗期间毒性与预后的相关性
抽象的
背景
癌症的免疫疗法改变了许多肿瘤的治疗方式,尤其是非小细胞肺癌(NSCLC)。在某些患者中,使用免疫检查点抑制剂(ICI)与新的免疫相关不良反应(ir-AEs)的发生有关。我们的目的是研究ir-AEs的出现与ICI的疗效之间是否存在任何相关性。方法
我们收集了2015年12月至2019年5月间在我院接受单药治疗的66例经诊断为晚期NSCLC并接受ICI治疗的患者的数据。包括临床,肿瘤相关和治疗等多个变量,并进行了单因素和多因素Cox回归分析。结果
队列由50名男性和16名女性组成,中位年龄为67岁,80%,东部合作肿瘤小组(ECOG)的工作状态为0-1。66%为积极吸烟者或曾吸烟者,而34%从未吸烟。62%的患者患有腺癌组织学,32%的鳞癌和3%的患者未另外指定(NOS)癌组织学。3%的患者在开始免疫治疗时进入III-B期,分别为36%M1a,35%M1b和24%M1c。2例患者的EGFR基因有驱动突变。53%的患者具有未知的PDL1状态;9%的人没有PDL1表达,9%的人低表达和27%的人高表达。82%的患者已发展到先前的治疗方案,而18%的患者未接受过治疗。irAEs发生在55%的患者中;11%的人产生3至4级毒性。较常见的irAE是疲劳(61%)和皮疹(32%)。通过Cox回归将单变量分析中的重要统计变量包括在多变量分析中。任何等级毒性的出现均与无进展生存期(PFS)改善有关(中位5.2个月vs 2.7个月; HR 3.53; p = 0.018; 95%CI [1.24-10.07])。ICI治疗期间使用皮质类固醇与PFS无关。结论
在ICI治疗期间出现免疫相关的不良反应与我们人群中更好的预后相关。在免疫疗法中使用皮质类固醇不会对治疗效果产生任何有害影响。负责研究的法人实体
作者。资金
尚未收到任何资金。揭露
所有作者均声明没有利益冲突。