Author of

• 18502

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  P3.02c - Poster Session with Presenters Present (ID 472)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Advanced NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 18545

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    P3.02c-043 - Immunotherapy in Non-Small Cell Lung Cancer: A New Approach and a New Challenge (ID 5614)

    14:30 - 14:30  |  Author(s): S. Campainha
    • Abstract

    Background:
    Effective options are limited for patients with non-small cell lung cancer (NSCLC) with progressive disease after first-line chemotherapy. In these patients, immune checkpoint modulators have recently proven to be successful targets, being nivolumab the first immune checkpoint inhibitor approved for NSCLC. In contrast to conventional chemotherapy, these agents appear to have potential for effecting durable responses and possibly long-term survival. Immune checkpoint inhibitors generate atypical types of tumour responses and have a specific toxicity profile which is challenging current practices. Objective: To investigate outcomes and adverse effects in patients treated with nivolumab.
    
    Methods:
    Stage IV NSCLC patients treated with nivolumab at our centre between 30th September 2015 and 30th June 2016 were retrospectively analysed. We describe clinical features, toxicity and outcomes in these patients.
    
    Results:
    Fifteen patients were included [mean age 62±8 years; mainly male (n=12)]. Almost all patients had a history of tobacco smoking (n=12; mean pack/year45). The observed histological type were adenocarcinoma (n=10) and squamous cell carcinoma (n=5). All patients received prior systemic therapy, mainly platinum based regimens. At time of the initiation of nivolumab most patients had an ECOG performance-status score of 1 (n=12) and stage IV cancer (n=10). Only one patient received subsequent cancer therapy and the remaining alive patients at time of the study was still under nivolumab treatment. Mean duration of treatment was 3.5months (median of 4 cycles). The median survival since the beginning of nivolumab was 2.3months (min 7days; max 8.7months). Treatment-related adverse events of grade 1 or 2 were reported in 20% of the patients: thyroid hormone alterations were present in 3 patients and 2 needed thyroid hormone replacement; 1 patient presented immune related eczema and another suspected myocarditis. Two patients suspended nivolumab temporarily and two patients died.
    
    Conclusion:
    Besides the efficacy profile of immune targeted agents it is important to be aware of possible immune-related adverse events. These toxicities remain largely unknown and will be more frequent in routine practice as the number of patients treated with nivolumab increases. Although severe adverse effects remain rare, they can become life-threatening if not anticipated and managed appropriately. Ongoing evaluation is needed to define the most appropriate timing and patient population that will benefit from therapy with an immune checkpoint inhibitors and to learn how to deal with its adverse effects.