58P Real-world data of incidence of immune related toxicities with single agent immuno oncology drugs at a single center

Abstract

IO agents have revolutionised the treatment in many solid cancers leading to improved overall survival and also quality of life. Although well tolerated, immune related toxicities have been an issue. Data about the same from the real world practise is little known. We aimed to evaluate the toxicity profile of IO agents across different solid cancers at our center .Consecutive patients who were treated with IO regimens between Jan 2018 and Feb 2020 were prospectively analysed for Immune related toxicities .They were graded as per Common Terminology Criteria for Adverse Events and managed as per NCCN guidelines for Immune Related Toxicities .All patients who received at least 2 doses of IO agents were included in the study. Between Jan 2018 and Feb 2020 ,115 patients were eligible and analysed for immune related toxicities .There were 62 females (53.9%) and 53 males (46.1%) .IO agents used were Nivolumab (n=56) ,Pembrolizumab (n=40) ,Atezolizumab (n=14) and Durvalumab (n=5) .Among different indications ,Metastatic NSCLC (21.7%) ,Bladder (12.1%) ,RCC (12.1%),HCC (11.3%) were most common .Incidence of all grades Immune Related Toxicities was 68.6% (n=79) .Grade ½ was seen in 60% (n=69) and grade ¾ was seen in 8.6%(n=10) .Most common toxicities were Hypothyroidism (35.4%) ,Pneumonitis(20.2%) ,Colitis (12.6%) ,Adrenal (7.5%) ,Hepatic (6.3%) ,Dermatologic (3.7%) ,Renal (3.7%) and Diabetes (3.7%) .Grade ¾ toxicities encountered were Pneumonitis (n=3) ,Colitis (n=2) ,GBS (n=1) ,Nephritis (n=1), Pancreatitis (n=1) ,Hypophysitis (n=1) and Hepatitis (n=1) .Grade 4 toxicity lead to 4 deaths in our study period. Immune Related Toxicities are as common in the real world as in the trial population often leading to discontinuation of the drug .Our study depicts the incidence of different toxicities encountered with single agent IO drugs at a single center.