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• W3136751016 abstract "Anti-PD-(L)1 immunotherapy (IO) leads to prolonged survival in selected patients (pts) with advanced non-small cell lung cancer (NSCLC). The clinical features, survival outcomes and long-term toxicities of NSCLC pts alive >1 year from IO start are poorly understood. Pts with histologically-confirmed stage III/IV NSCLC alive >1 year after IO start were defined as IO survivors, and identified from an IRB-approved institutional database between 11/2009-2/2020. Demographics, treatment, immune-related adverse events (irAEs) were identified via retrospective chart review. Overall survival (OS) was defined as time from IO start until death from any cause. Of 317 NSCLC pts treated with IO, 114 NSCLC survivors were identified (36%). The median age was 66 years (range: 42-87), most were male (54%), former/current smokers (82%), with adenocarcinomas (67%, 76/114), and 34% harbored KRAS mutations (32/114). Most pts received standard-of-care IO (52%, 59/114) in the 1st/2nd-line setting (82%, 94/114), and nivolumab was the most common IO given (nivo=39%; nivo/ipi=11%; pembro= 18%; durva= 7%; other anti-PD-(L)1= 1%; PD-(L)1+chemo= 11%; PD-(L)-1+other= 13%). Median number of IO doses received was 13 (range: 1-121). Median OS was 26.5 mos (range 12.2-106.9 mos), and median PFS was 13 mos (range: 0.7-106.9 mos) in the entire cohort. Most IO survivors (52%, 59/114) experienced an irAE of any-grade (1 irAE= 34%; 2 irAEs= 11%; 3+ irAEs= 7%). Development of an irAE was associated with improved median PFS (irAE: = 21.2 mos, no irAE:= 9.8 mos, p=0.002), but not OS (irAE: 28.5 mos vs. no irAE: 24.5 mos, p= 0.28). The most common irAEs were pneumonitis (18%), dermatitis (11%), and inflammatory arthritis (IA) (11%), and the majority were low grade (CTCAE Grade 1-2= 78%, 73/94; Grade 3+= 22%, 21/94). Median time to onset of first irAE was 3.5 mos (range 0-33.7 mos). Most were treated with steroids alone (51%, 30/59) or with additional immunosuppression (12%, 7/59). irAEs led to discontinuation of IO in 29 survivors (25%). Of IO survivors experiencing irAEs, 59% (35/59) had ongoing irAEs at time of death or last follow-up. Seven IO survivors developed irAEs after discontinuation of IO therapy (IA=3, IA and colitis= 1, colitis =1, pruritus =1, aplastic anemia=1). The majority of IO survivors (51%, 31/59) were still receiving treatment for pneumonitis (4), thyroid dysfunction (10), hypophysitis (3), IA (5), colitis (4), dermatitis (4), Type 1 Diabetes (1), and pancreatitis (1) 1-year post IO start. Almost half (45%, 14/31) were still on steroids, and 16% (5/31) were on additional immunosuppression (methotrexate, cyclosporine, and mycophenolate). In a real-world cohort, 36% of NSCLC pts survived >1 year after IO start, with an unprecedented median OS of 26.5 months. The majority of IO survivors developed irAEs, more than half of which had long-term irAEs requiring ongoing immunosuppressive management 1-year post IO start. These data could be used to develop an IO survivorship program, focusing on long-term toxicity management." @default.
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• W3136751016 title "MA07.05 Survivors from Anti-PD-(L)1 Immunotherapy in NSCLC: Clinical Features, Survival Outcomes and Long-term Toxicities" @default.
• W3136751016 doi "https://doi.org/10.1016/j.jtho.2021.01.186" @default.
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