Tumori Journal Abstract Book - October 2020 - 21

A - Thoracic Cancers	
Background: Immune-related thyroid dysfunction (irTD)
is common and occurs in 10-20% of patients treated with
immune checkpoint blockade and it seems to correlate
with improved outcomes. The proportion of the patients
who needs therapy for irTD, as well as the need to delay,
omit or interruption is not well known.
Patients and methods: We reviewed the data of 85pts
with metastatic NSCLC treated with PD1/PD-L1 blockade at our institution from July 2015 to April 2020. The
incidence of immune-related thyroid disfunction (irTD),
requiring delay, omission, or permanent discontinuation,
and the need for hormonal replacement or antithyroidal
drugs were assessed. Patients with pre-existent thyroid
disease, patients who did not receive at least two immunotherapy courses or who did not perform at least two dosages of thyroid hormones (TSH, FT3, FT4) were excluded
from the analysis. The severity of adverse events is graded
using CTCAE v. 4.03.
Results: 75 pts were enrolled (M/F = 49/26), median age 69
years (range 37-82), ECOG PS 0-1 in 70 pts and PS 2 in 5
pts. 10 pts were excluded for pre-existent TD. At the time of
analysis, the median number of administered courses was 8
(range 2-75), 55 pts received nivolumab, 12 pts pembrolizumab and 8 pts atezolizumab. Primary TD was found in 19
patients (25.3%), which is similar to that reported in previous
studies, after a median of 5 cycles of therapy (range 1-42). 5
pts developed hypothyroidism (G2 in 4 pts and G3 in 1 pts)
and needed hormone replacement, 4 pts experienced G2
hyperthyroidism and were treated with metimazole. 1 pt had
G2 hyperthyroidism, followed by G2 hypothyroidism due to
thyroiditis. Other TD were subclinical hyperthyroidism in 6
pts and subclinical hypothyroidism in 4 pts. 3 pts delayed
immunotherapy due to TD, 2 pts omitted an immunotherapy
course and 1 pt permanently discontinued treatment due to
hypothyroidism. Approximately, 50% of these pts required
hormonal replacement or antithyroidal drugs. ORR was
14.7% (11 PR + 0 CR) and the DCR was 48% (25 SD + 11
PR). The median PFS was 4.9 months, the 6-month PFS rate
was 39.7% and the 12-month PFS rate was 24.7%. In patients
who developed irTD the median PFS was 15.7 months vs 3.6
months in those who did not (p<0.001).
Conclusions: Accordingly, with other studies, our data
confirms that the development of irTD relates with better
outcomes and that thyroid function monitoring must be
routinely tested during therapy with immune checkpoint
inhibitors (PD1/PD-L1).

21
1
Clinica Oncologica, Università Politecnica delle Marche, Azienda
Ospedaliero-Universitaria Ospedali Riuniti Umberto I - GM Lancisi - G
Salesi, Ancona/Italy, Ancona

Background: Due to frail clinical conditions and comorbidities, the management of NSCLC in elderly patient is
still controversial. In several studies, first-line double
chemotherapy demonstrated to improve survival compared to mono-chemotherapy, despite of important toxicity. However, these data emerge from randomized
controlled trials (RCTs), in which this setting of patients is
underrepresented and often selected according comorbidity. In clinical practice, most patients are unfit for a platinum-based chemotherapy. We report our experience with
monochemotherapy in metastatic NSCLC elderly patients.
Methods: We retrospectively analyzed data about consecutive ⩾ 75 years old patients who started a first line monochemotherapy treatment at our Institution (Università
Politecnica Marche, Italy) and Evangelische Lungenklinik
(ELK) of Berlin for advanced NSCLC, between September
2003 and August 2017. Tumor response was assessed
using the Response Evaluation Criteria In Solid Tumors
(RECIST). Progression free survival (PFS) and overall
survival (OS) were estimated using Kaplan-Meier method.
A Cox regression model was carried out for univariate and
multivariate analyses.
Results: Eighty-eight patients were enrolled, males 75
(85%) and females 13 (15%). Median age was 86 (range
76-96). 32 (36%) received carboplatin and 56 (64%) other
mono-chemotherapy regimens (mainly vinorelbine and
gemcitabine). 20% of them had a poor Performance Status
(PS) at the start of first line treatment, according to the
Eastern Cooperative Oncology Group (ECOG) system
(ECOG >2). Median Overall Survival (mOS) was 11.4
months (m), median follow-up was 35.2 m. A statistically
significant difference between carboplatin and other single
agents was not found in terms of OS (11.4 m vs 13.0 m
respectively, p= 0.2) and PFS (6.5 m vs 4.0 m respectively,
p= 0.5). At multivariate analysis sex, smoking history, histology, did not result as prognostic and predictive factors.
Conclusions: Currently only 30% of patients with PD-L1
>50% can be treated first-line with immunotherapy alone.
Platinum-based chemotherapy or chemo-immunotherapy
for patients with non-squamous histology represent the
standard in case of PD-L1 < 50%. This study suggests that
carboplatin mono-chemotherapy might represent a valid
option as first line treatment in elderly and very elderly
patients in real life, not eligible for a first line double platinum-based chemotherapy.

A31
Options of first line
monochemotherapy in metastatic
NSCLC elderly patients: a real-life
experience
Meletani T.1, Rinaldi S.1, Marcantognini G.1, Lenci E.1, Fiordoliva I.1,
Cantini L.1, Di Pietro Paolo M.1, Mazzanti P.1, Burattini L.1, Berardi R.1

A32
IMPACT OF BASELINE SYSTEMIC
INFLAMMATION SCORES IN PATIENTS
WITH NSCLC TREATED WITH
IMMUNOTHERAPY: A PROPENSITY
MATCHED SCORE ANALISYS



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
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