Immune-related Adverse Events Associated with PD-1/PD-L1 Inhibitors in Metastatic NSCLC Patients: A Single-Center Study from Hong Kong
Refereed conference paper presented and published in conference proceedings
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AbstractIntroduction
Real-wold data on immune-related adverse events (irAEs) related to anti-programmed-death (PD1) or programmed death ligand-1 (PDL1) antibodies in metastatic non-small cell lung cancer (NSCLC) remains scarce. This study examined the incidence, time to onset, management, and predictive risk factors of irAEs among patients with NSCLC in Hong Kong.
Methods
This is a retrospective review of patients diagnosed with NSCLC and were treated with PD-1/PD-L1 inhibitors at the Prince of Wales Hospital between June 2016 and March 2020. Clinical data on the incidence, onset and management of irAEs were extracted from electronic health records and presented using descriptive statistics. Poisson regression was conducted to identify clinical risk factors of irAEs.
Results
This review included 121 patient (74% male; median age 62.5 years [range: 21-89]; 64% EGFR positive). They were treated with atezolizumab (n=27), pembrolizumab (n=38) or nivolumab (n=56). In total, 187 any-grade irAEs were observed in 66 patients (54.5%), of which 7 events were categorized as grade III/IV serious events (5.7%). The median time to onset of any-grade and grade III/IV irAEs were 70.5 days (range: 2-1002 days) and 142 days (range: 15-571 days), respectively (Figure 1). The peak of onset of irAEs was within 6 weeks of treatment. The majority of the patients who experienced irAEs were managed by symptomatic relief treatment. However, 11 cases
required systemic corticosteroids for pneumonitis (n=6), liver function test derangement (n=2), thrombocytopenia (n=1), colitis (n=1), or encephalopathy (n=1). Eight cases required hormone supplement therapy. Chronic infections (RR=1.49, 95% CI=1.01-2.21), absence of EGFR mutation (RR=0.26, 95% CI=0.109-0.662), and PD-L1 expression ≥50% (RR=2.28, 95% CI=1.588-3.287) were significantly associated with the occurrence of irAEs.
Conclusions
Our data suggests that half of the patients treated with PD-1/PD-L1 inhibitors experienced irAEs. This real-world data would advise the development of institutional protocols for monitoring/managing immunotherapy-induced toxicities in at-risk patients.
Real-wold data on immune-related adverse events (irAEs) related to anti-programmed-death (PD1) or programmed death ligand-1 (PDL1) antibodies in metastatic non-small cell lung cancer (NSCLC) remains scarce. This study examined the incidence, time to onset, management, and predictive risk factors of irAEs among patients with NSCLC in Hong Kong.
Methods
This is a retrospective review of patients diagnosed with NSCLC and were treated with PD-1/PD-L1 inhibitors at the Prince of Wales Hospital between June 2016 and March 2020. Clinical data on the incidence, onset and management of irAEs were extracted from electronic health records and presented using descriptive statistics. Poisson regression was conducted to identify clinical risk factors of irAEs.
Results
This review included 121 patient (74% male; median age 62.5 years [range: 21-89]; 64% EGFR positive). They were treated with atezolizumab (n=27), pembrolizumab (n=38) or nivolumab (n=56). In total, 187 any-grade irAEs were observed in 66 patients (54.5%), of which 7 events were categorized as grade III/IV serious events (5.7%). The median time to onset of any-grade and grade III/IV irAEs were 70.5 days (range: 2-1002 days) and 142 days (range: 15-571 days), respectively (Figure 1). The peak of onset of irAEs was within 6 weeks of treatment. The majority of the patients who experienced irAEs were managed by symptomatic relief treatment. However, 11 cases
required systemic corticosteroids for pneumonitis (n=6), liver function test derangement (n=2), thrombocytopenia (n=1), colitis (n=1), or encephalopathy (n=1). Eight cases required hormone supplement therapy. Chronic infections (RR=1.49, 95% CI=1.01-2.21), absence of EGFR mutation (RR=0.26, 95% CI=0.109-0.662), and PD-L1 expression ≥50% (RR=2.28, 95% CI=1.588-3.287) were significantly associated with the occurrence of irAEs.
Conclusions
Our data suggests that half of the patients treated with PD-1/PD-L1 inhibitors experienced irAEs. This real-world data would advise the development of institutional protocols for monitoring/managing immunotherapy-induced toxicities in at-risk patients.
Acceptance Date02/05/2023
All Author(s) ListDerek Man Him Ng, Herbert Ho Fung Loong, Yat Ming Lau, Kit Man Li, Yin Ting Cheung, Kai Him So, Keary Rui Zhou
Name of ConferenceMultinational Association of Supportive Care in Cancer (MASCC)/ Japanese Association of Supportive Care in Cancer (JASCC)/ International Society of Oral Oncology (ISOO) Annual Meeting 2023
Start Date of Conference22/06/2023
End Date of Conference24/06/2023
Place of ConferenceNara
Country/Region of ConferenceJapan
Proceedings TitleJournal of Supportive Care in Cancer
Year2023
Month6
Day17
Volume Number31
Issue NumberSupp. 1
PublisherSpringer
Article number399
Pages78 - 79
LanguagesEnglish-United States
KeywordsImmunotherapy, NSCLC, immune-related adverse events, lung cancer, checkpoint inhibitors
