(155) Incidence of Endocrine Toxicities in Patients with Solid Tumor Malignancies Receiving Curative-intent Immune Checkpoint Inhibitor (ICI) Therapy: A Single Institution Experience

Poster Abstract:

Background: Immune checkpoint inhibitors (ICIs) are used across several solid tumor malignancies. The mechanism and site of action varies depending on the agent, but ultimately leads to immune system activation by targeting key regulators of immune tolerance. It is widely accepted that toxicities secondary to ICIs are a result of persistent activation of the immune system causing autoinflammation throughout the body and resulting in adverse events that can manifest in nearly all organs, including endocrinopathies. However, current literature suggests limited recovery of endocrine function after endocrinopathies, thus necessitating lifelong hormone supplementation. The expansion of ICI approvals and incorporation in early stage and curative settings has resulted in potential endocrinopathies and life-long sequalae in more patients. Although the recognition of endocrinopathies has improved with its expanded use, the incidence should be evaluated in the real-world setting.

Objectives: The primary objective is to evaluate the incidence of select endocrine toxicities secondary to curative-intent ICI therapy in patients with solid tumor malignancies. The secondary objectives will include assessment of severity, time to onset, and recovery of adrenal function. Risk factors for development of endocrine toxicities, including older age, pre-existing autoimmune disease, and the ICI agent used for treatment will be analyzed as exploratory objectives.

Methods: This is an observational, retrospective, single-center, cohort study of patients with solid tumor malignancies receiving ICIs for curative intent at Levine Cancer Institute. Patients will be eligible if they are ≥ 18 years old and received curative-intent ICI therapy for a solid tumor malignancy between May 1, 2022 and March 30, 2023. An estimated 500 records will be included in this study. Manual collection and electronic medical record queries will supplement data elements.

Results: pending

Discussion: pending

References (must also be included in final poster): 1. Wright JJ, Powers AC, Johnson DB. Endocrine toxicities of immune checkpoint inhibitors. Nat Rev Endocrinol. 2021;17(7):389-399. doi:10.1038/s41574-021-00484-3
2. Brahmer JR, Lacchetti C, Schneider BJ, et al. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2018;36(17):1714-1768. doi:10.1200/JCO.2017.77.6385
3. Byun DJ, Wolchok JD, Rosenberg LM, Girotra M. Cancer immunotherapy - immune checkpoint blockade and associated endocrinopathies. Nat Rev Endocrinol. 2017 Apr;13(4):195-207. doi: 10.1038/nrendo.2016.205. Epub 2017 Jan 20. PMID: 28106152; PMCID: PMC5629093.
4. Abdel-Rahman O, ElHalawani H, Fouad M. Risk of endocrine complications in cancer patients treated with immune check point inhibitors: a meta-analysis. Future Oncol. 2016;12(3):413-425. doi:10.2217/fon.15.222
5. Barroso-Sousa R, Barry WT, Garrido-Castro AC, et al. Incidence of Endocrine Dysfunction Following the Use of Different Immune Checkpoint Inhibitor Regimens: A Systematic Review and Meta-analysis. JAMA Oncol. 2018;4(2):173-182. doi:10.1001/jamaoncol.2017.3064