2022 World Conference on Lung Cancer (ePosters)-EP08.01-067. Rechallenging with PD-1 Inhibitors: Incidence and Management of Immune-Related Adverse Events in Metastatic NSCLC

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This study aimed to investigate the incidence and management of immune-related adverse events (irAEs) in metastatic non-small cell lung cancer (NSCLC) patients treated with PD-1 inhibitors. The researchers conducted a review of patients who received at least one dose of PD-1 inhibitors between 2013-2021. They excluded patients who received combination treatment with CTLA-4 inhibitors.<br /><br />The baseline characteristics of the patients included age, gender, smoking status, Eastern Cooperative Oncology Group (ECOG) performance status, tumor histology, PD-L1 expression, EGFR and ALK mutation status, pre-existing autoimmune disease, and line of treatment. The overall incidence of irAEs was found to be 38%.<br /><br />The study also assessed the rechallenge of PD-1 inhibitors after an irAE and its impact on clinical outcomes. The researchers found that there were no significant differences in clinical outcomes between patients who were rechallenged with PD-1 inhibitors compared to those who discontinued therapy. Subset analyses of specific irAEs were suggested to provide further insight into the benefits of PD-1 inhibitor rechallenge.<br /><br />The incidence and grades of specific irAEs were presented in Figure 1, and the management of patients with irAEs was shown in Figure 2. The study found that 52% of patients with non-endocrine only irAEs were rechallenged, and 46% of patients were successful with no recurrence of the same irAE or the occurrence of a new irAE. No treatment-related deaths were associated with rechallenge.<br /><br />The overall median progression-free survival (PFS) and overall survival (OS) from the time of the first irAE were 6.0 months and 21.6 months, respectively. There was no significant difference in PFS or OS observed between subgroups of patients who permanently discontinued PD-1 inhibitors, continued therapy, or were rechallenged.<br /><br />In conclusion, this study provides insight into the incidence and management of irAEs in metastatic NSCLC patients treated with PD-1 inhibitors. The findings suggest that rechallenge with PD-1 inhibitors is feasible and does not significantly affect clinical outcomes. Further research on specific irAEs and their impact on rechallenge may provide additional understanding of the benefits of this approach.

Asset Subtitle

Tuan Hoang

Meta Tag

Speaker Tuan Hoang

Topic Metastatic Non-small Cell Lung Cancer - Immunotherapy

Keywords

immune-related adverse events

metastatic non-small cell lung cancer

PD-1 inhibitors

incidence

management

review

baseline characteristics

rechallenge

clinical outcomes

progression-free survival