Tumori Journal Abstract Book - October 2020 - 27

A - Thoracic Cancers	
toxicity with only 3 G4 events which led to the definitive
discontinuation of treatment. Toxicities were mostly found
in male subjects <70 years of age.
Conclusions: Immune checkpoint inhibitors are drugs with
enormous potential efficacy could change the prognosis of
several highly inauspicious oncological diseases. Toxicity
profile usually appears manageable and differs from traditional chemotherapy. The increasingly frequent and prolonged use in clinical practice will lead to greater knowledge
and investigation of possible toxicities. To date, there are
no direct comparison studies between the various immunotherapics in terms of efficacy and side effects, therefore
they all represent valid therapeutic alternatives.

27
higher median age of the pts treated. Updated data will be
presented at the congress.

A43
Is gastro-intestinal toxicity
related with prolonged clinical
benefit in non-small cell lung
cancer patients treated with
immunotherapy?
Guaitoli G.1, Baldessari C.1, Trudu L.1, Di Emidio K.1, Dominici M.1,
Bertolini F.1, Barbieri F.1
1

Azienda Ospedaliero - Universitaria Policlinico di Modena, Modena

A42
Real world data on
Immunotherapy (IT) in metastatic
NSCLC: a General Hospital, single
institution, retrospective
analysis
Beshiri K.1, Sogno G.1, Ponzanelli A.2, Benasso M.1
1

San Paolo Hospital, Savona; 2Santa Corona Hospital, Pietra Ligure

Background: IT has become the cornerstone in the treatment of advanced NSCLC. Data from real world are still
incomplete. This is an observational retrospective analysis
on patients (pts) treated with IT in clinical practice in the
Oncology Unit of the San Paolo Hospital, Savona and
Santa Corona Hospital, Pietra Ligure.
Methods: Eligibility criteria included stage IV histologically confirmed NSCLC treated with IT as first or second
line therapy in our Unit from May 2016 to November
2019. The aim of the analysis was to assess the outcomes
and safety of IT in these subsets of pts in our daily clinical
practice compared to the pivotal trials.
Results: We retrospectively collected data on 57 patients:
43 pts (24 adenocarcinoma and 19 SCC) received
Nivolumab (NIVO) as second line treatment, while 15 pts
(11 adenocarcinoma and 4 SCC) received Pembrolizumab
(PEMBRO) alone as first line. The median age was 72
years (range: 52-85) in NIVO group, and 80 years (range:
52-83) in PEMBRO group. On December 2019, pts evaluable for response were 39 in NIVO group and 15 in
PEMBRO group. Responses in NIVO group were 12/39
(ORR: 30.7%). One of these pts with adenocarcinoma had
a complete response. Responses in PEMBRO group were
9/15 (ORR: 60%). 13 pts (30.2%) in NIVO group and 7 pts
(46.6%) were alive at 12 months. The most common
adverse events were asthenia, diarrhea and thyroiditis. No
grade III-IV toxicities were reported.
Conclusions: In our daily clinical practice the ORRs of pts
treated with IT were higher than in pivotal trials despite the

Background: Immune checkpoint inhibitors (ICIs) are
widely used in the treatment of NSCLC. Despite immunotherapy (IT) is generally well tolerated, immune-related
adverse events occur in about one third of patients, and
gastro-intestinal (GI) toxicity is one of the most common.
Here, we describe a small subgroup of NSCLC patients
that discontinued IT due to GI toxicity and experienced
prolonged clinical benefit after discontinuation.
Material and methods: We performed a retrospective
review of NSCLC patients who started IT at Modena
University Hospital between August 2015 and December
2018 and we selected patients who experienced grade ⩾2
diarrhea and underwent colonoscopy with histological
examination.
Results: A total of 6 Caucasian patients were included (2
males and 4 females). Median age at diagnosis was 68.5
years (range 46-77). Three patients were treated with pembrolizumab as first line treatment and 3 with nivolumab in
second or third line. Median duration of treatment was 10
months (95% CI 2.2-18.8). GI toxicity appeared after a
median time of 4.5 months (95% CI 1.2-14). All patients
were treated with steroids without significant benefit and
in all cases stool culture was performed to exclude infectious causes. Endoscopic findings were normal in 2/6
cases, while in the remaining hyperemia and edema were
detected, with mucosal erosions in one case. The most
common histologic findings were chronic inflammation of
the lamina propria (67%) and eosinophils infiltration
(67%). Given the absence of benefit with steroids, in four
cases mesalazine was started with clinical benefit. Four
patients had partial response as best response to IT, and 1
patient achieved complete metabolic response, that is still
maintained after one year from nivolumab discontinuation. After a median follow up of 28 months, 5 patients are
currently alive and 1 was lost at follow up. In 3 cases
(50%) disease progressed and a subsequent treatment was
administered. Median time between the end of ICIs treatment and the beginning of new treatment or last observation was 14.5 months (95% CI 3.5-27.8).



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
Tumori Journal Abstract Book - October 2020 - 1
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