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J. Shimizu
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P2.07 - Immunology and Immunotherapy (ID 708)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Immunology and Immunotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.07-028 - Efficacy and Safety of Nivolumab in Non-Small Cell Lung Cancer Patients Who Relapse after Thoracic Radiotherapy (ID 8928)
09:30 - 09:30 | Author(s): J. Shimizu
- Abstract
Background:
In patients undergoing thoracic radiotherapy (TRT), anti-programmed cell death-1 (PD-1) antibodies including nivolumab and pembrolizumab may enhance cytotoxic effects. However, the risk of pneumonitis may be increased and this issue is truly worthy of consideration.
Method:
We retrospectively evaluated a total of 42 patients with non-small cell lung cancer who relapsed after TRT with or without concurrent chemotherapy and have undergone nivolumab at two institutions between December 2012 and May 2017.
Result:
The median age of all patients was 67.5 years (range 39–76 years), and 5 patients (12%) were female. Five patients (12%) had postoperative recurrent disease, 7 patients (17%) had stage IV disease and the remaining 30 patients (71%) had stage III disease. Thirty patients (71%) received thoracic radiotherapy concurrent with cytotoxic chemotherapy. Eleven patients received nivolumab within 6 months after completion of TRT (Group A) and 31 patients received nivolumab more than 6 months after completion of TRT (Group B). For the patients in this study, response rate (RR) was 19% and median progression-free survival was 3.2 months. Group A had significantly shorter PFS than Group B (Group A; 1.4 months vs Group B; 5.5 months, p=0.018, log-rank test). Nine patients (21%) experienced possible treatment-related pneumonitis, two patients were in Group A and 7 patients were in Group B. All three patients who experienced grade 5 pneumonitis were in Group B; received nivolumab after 9 months, 11 months and 46 months after completion of TRT, respectively.
Conclusion:
Patients who were resistant to TRT had significantly shorter PFS. Regarding pulmonary toxicity, the risk of pneumonitis may be higher in the patients who received nivolumab after TRT and more attention should be paid to the patients who received it more than 6 months of completing TRT.
