(199) Real World Outcomes of Patients Receiving Immune Checkpoint Inhibitors in the Inpatient Setting

Poster Abstract: Background/Rationale:
Immune checkpoint inhibitors (ICI) are a treatment option for different types of cancers including, but not limited to, non-small cell lung cancer, melanoma, and breast cancer. By blocking checkpoint proteins from binding with their protein partners, T-cells remain activated and target proliferative cancer cells. In the studies that provided rationale for ICI therapy, many of the patients were of better performance status (ECOG 0-1) than patients who are admitted. ICI therapy also takes several months until the efficacy is realized. In addition to delayed tumor response, some patients may experience an initial tumor flare reaction in response to immunotherapy prior to tumor shrinkage.

Management of therapeutics is an important part of maintaining the financial integrity of the healthcare system. ICI therapy can be costly and may not be reimbursed when given in the inpatient setting. Given their novel place in therapy, delayed onset of action, and high inpatient cost – there is limited data to support their use in the acute care setting. Further studies are required to assess the safety and appropriateness of inpatient administration of ICI and relevant real-world clinical outcomes.

Our study aims to aggregate multiple endpoints applied to adult patients with confirmed diagnoses of solid malignancy and identify characteristics correlated with response to ICI therapy. Our study will also assess real world outcomes of inpatient ICI use given that patients with poorer performance status and patients with advanced disease were excluded from the prospective clinical trials.

Methods:
This is a single center, retrospective chart review study assessing patients with a confirmed diagnosis of a solid malignancy who received at least one dose of inpatient ICI therapy at the University of California, San Francisco (UCSF) Medical Center between January 1st, 2014 through March 31st, 2023. Patients were excluded if they were enrolled in a concurrent clinical trial. The primary outcome is overall survival and progression free survival. Secondary outcomes include assessing positive predictors of ICI response, monetary impact of ICI therapy, and characterizing patients disposition post admission.

Results:
Results are pending.

Conclusion/

Discussion:
Conclusions are pending.

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