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Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2018 ASCO Annual Meeting but not presented at the Meeting, can be found online only.

Impact of comorbidity on immune checkpoint blockade tolerance across tumor types.

Sub-category:
Immune Checkpoint Inhibitors

Category:
Developmental Therapeutics—Immunotherapy

Meeting:
2018 ASCO Annual Meeting

Abstract No:
e15068

Citation:
J Clin Oncol 36, 2018 (suppl; abstr e15068)

Author(s): Sean Clark-Garvey, Thomas Holden, Daniel S. Altman, Sheel A. Patel, Sharon Li, Reetu Mukherji, Philip Margiotta, Mario Caldararo, Marlana M. Orloff, Jennifer Maria Johnson, Ryan Michael Weight; Thomas Jefferson University, Philadelphia, PA; Thomas Jefferson University, Philadelphia, PA, US; Jefferson Medcl Coll, Bethesda, MD; Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA; Thomas Jefferson University, Department of Medical Oncology, Philadelphia, PA

Abstract Disclosures

Abstract:

Background: Immune Checkpoint Blockade (ICB) has demonstrated efficacy across a variety of tumor types. However, treatment is often complicated by immune related adverse events (irAEs), leading to discontinuation of therapy. Patients with poor performance status are excluded from most clinical trials. Therefore, the effect of comorbid conditions on the development irAEs is unknown. We analyzed a large single institution registry to determine the correlation of comorbidity and discontinuation of ICB across tumor types. Methods: A single institution registry of 113 patients who received and discontinued ICB, (ipilimumab [n = 18], nivolumab [n = 33], pembrolizumab [n = 18], atezolizumab [n = 4]) was reviewed. Reasons for discontinuing ICB were analyzed by tumor type and immunotherapy agent. Tumor subtypes included: Melanoma (43), NSCLC (40), Bladder (9), and other (21). ECOG PS and Charleston Comorbidity Index (CCI) were independently analyzed and correlated with development of irAEs. Results: The most common cause for discontinuation across all tumors was POD (64.6%); while 18.6% discontinued due to irAEs. Interestingly, there was no statistically significant difference between the rate of treatment-limiting irAEs and ECOG PS (p = 0.12) or CCI (p = 0.99). Only 1 of 18 patients with an ECOG PS of 2-3 discontinued therapy due to an irAE. See Table 1 Conclusions: Pre-treatment comorbidity did not influence the discontinuation rate of immune checkpoint blockage due to irAEs. The low rate of therapy discontinuation in patients with poor performance status and high comorbidity index provides insight into the application of immune checkpoint blockage outside of a clinical trial.

Table 1. Treatment Discontinuation Rates by Immunotherapy Type, ECOG PS, and CCI

Reasons for Discontinuation
Progression of
Disease (POD)
irAEsComorbidity/
Other Toxicity/
Death
Number of patients, n (%)73 (64.6)21 (18.6)19 (16.8)
ECOG PS, n (%)
013 (46.4)9 (32.1)6 (21.5)
134 (64.2)9 (17)10 (18.8)
2-314 (77.8)1 (5.6)3 (16.6)
CCI (Mean)*8.17.717.67
Treatment, n (%)
Nivolumab33 (68.8)5 (10.4)10 (20.8)
Pembolizumab18 (75)2 (8.3)4 (16.7)
Ipilumumab18 (52.9)14 (41.2)2 (5.9)
Atezolizumab4 (57.1)0 (0)3 (42.9)

*Reported as the average value for all patients.

 
Other Abstracts in this Sub-Category:

 

1. ICONIC: Biologic and clinical activity of first in class ICOS agonist antibody JTX-2011 +/- nivolumab (nivo) in patients (pts) with advanced cancers.

Meeting: 2018 ASCO Annual Meeting Abstract No: 3000 First Author: Timothy Anthony Yap
Category: Developmental Therapeutics—Immunotherapy - Immune Checkpoint Inhibitors

 

2. Anti-CD27 agonist antibody varlilumab (varli) with nivolumab (nivo) for colorectal (CRC) and ovarian (OVA) cancer: Phase (Ph) 1/2 clinical trial results.

Meeting: 2018 ASCO Annual Meeting Abstract No: 3001 First Author: Rachel E. Sanborn
Category: Developmental Therapeutics—Immunotherapy - Immune Checkpoint Inhibitors

 

3. NKTR-214 (CD122-biased agonist) plus nivolumab in patients with advanced solid tumors: Preliminary phase 1/2 results of PIVOT.

Meeting: 2018 ASCO Annual Meeting Abstract No: 3006 First Author: Adi Diab
Category: Developmental Therapeutics—Immunotherapy - Immune Checkpoint Inhibitors

 

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