2043 - Correlation between irAEs and Efficacy of Consolidative PD-(L)1 Inhibitors Following Chemoradiotherapy in Locally Advanced Non-Small Cell Lung Cancer

X. Wang¹, Y. Ge², J. Zhang³, Q. Cheng⁴, S. Wang⁵, L. Wang⁵, X. Fu³, D. Wang⁵, J. Wu⁶, H. Sun³, Y. Gan³, and A. Gao⁷; ¹Shandong Cancer Hospital and Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, ShanDong, China, ²Shandong University Cancer Center, Jinan, Shandong, China, ³Shandong Cancer Hospital and Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, jinan, shandong, China, ⁴Shandong Cancer Hospital and Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, jinan, China, ⁵Shandong Cancer Hospital And Institute,Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ShanDong, China, ⁶Shandong Cancer Hospital and Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, jinan, shand, China, ⁷Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China

Purpose/Objective(s): PD-(L)1 inhibitor consolidation after concurrent or sequential chemoradiotherapy have revolutionized the treatment of locally advanced non-small cell lung cancer (LA-NSCLC). However, whether the occurrence of immune-related adverse events (irAE) affects the clinical outcomes of LA-NSCLC patients is undetermined. Here we aimed to investigate the correlation between irAEs of PD-(L)1 inhibitor.

Materials/

Methods: This retrospective study enrolled LA-NSCLC patients who received PD-(L)1 immunoconsolidation therapy following concurrent or sequential chemoradiotherapy between January 2019 and December 2022.The frequency, severity, involved systems, and timing of irAE were analyzed. The progression-free survival (PFS) and overall survival (OS) were used as the endpoints of clinical efficacy.

Results: A total of 125 patients were included, with a median age of 62 years. 67 patients (53.6%) developed irAEs and 58 patients (46.4%) didn’t. The most common irAEs were respiratory toxicity (N=35, 44.9%), endocrine toxicity (N=21, 26.9%), and digestive system toxicity toxicity (N=16, 20.5%). 92.3% patients experienced grade 1-2 irAEs and 5% experiencing grade 3-4 irAEs. We found that patients experiencing irAEs had significantly longer PFS (33.18 vs. 17.77 months, P=0.0018) compared to those without irAEs.. The development of grade 1-2 irAEs predicted superior PFS (NA vs. 17.77 months, P<0.001) and OS (P<0.001) while the development of grade 3-4 irAEs indicated worse PFS and OS, compared with no irAE group. In terms of involved systems, patients experiencing endocrine system irAEs rather than pneumonia or hepatic and renal injuries, showed better PFS (NA vs. 19.25, P=0.03) compared to their counterparts. In addition, patients developing single-system irAEs displayed better PFS compared with no irAEs ones. For the timing of irAEs, occurrance of irAEs within 2 months of immunotherapy rather than =2 months was associated with improved PFS.

Conclusion: In LA-NSCLC patients receiving consolidative PD-(L)1 inhibitors, the occurrence of irAEs predicted better PFS. Further analysis revealed that irAEs, of grade 1-2, single-system involvement, or early occurrence rather than that of grade 3-4, multi-system involvement, or late occurrence are are correlated with improved survival.