In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. e17087-e17087
Abstract:
e17087 Background: The success of immunomodulatory antibodies have led to their increasing investigation in GYN cancers. Many of these patients, however, discontinue the drugs early in treatment due to symptomatic progression, making it challenging to assess clinical benefit and late responses associated with these agents. Here, we describe the clinical characteristics underlying early progression requiring immunotherapy discontinuation in order to better guide patient selection for such trials. Methods: A retrospective analysis was performed on all GYN cancer patients treated with immunomodulatory antibodies at MSKCC between 1/2013 and 6/2016. Patients were defined as early progressors if they had clinical/radiographic disease progression before 12 weeks which required therapy discontinuation. Logistic regression was applied to model the relationship between baseline clinical and radiographic characteristics and early progression. P 〈 0.05 was considered to be statistically significant. Results: A total of 105 patients met the inclusion criteria, with 74 (71%) with ovarian cancer. Therapeutic targets included CTLA-4 (3%), and PD-1/PD-L1 alone and in combination with other targets (97%). Of these, 55 (52%) met the criteria for early progression requiring therapy discontinuation (median therapy duration 7 weeks, range 1.6-12.1). There was an increased risk for early progression in patients with pre-treatment ascites (p=0.005, OR 6.4, 95% CI 1.7-23.7), and with baseline bulky disease, defined by at least one tumor measuring ≥ 5cm, compared to patients with tumors 〈 5cm (p=0.001, OR 4.1, 95% CI 1.7-9.9). Clinical symptoms/deterioration were the reason for early discontinuation in 35 (64%) of the patients, with symptomatic ascites and abdominal pain as the most common complaints. Conclusions: Symptomatic clinical progression of peritoneal disease leading to early discontinuation of immunomodulatory antibody therapy is common in patients with GYN cancers and is associated with increased pre-treatment disease volume. The extent of peritoneal disease should be taken into strong consideration when selecting GYN cancer patients for trials with immunomodulatory antibody therapy.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2017.35.15_suppl.e17087
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2017
detail.hit.zdb_id:
2005181-5
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