(134) Impact of COVID-19 Infection on Immune Checkpoint Inhibitor Pneumonitis

Poster Abstract:

Background: Immune checkpoint inhibitors (ICI) are used for several types of cancers including but not limited to colorectal, renal, lung and bladder cancers. Side effects with ICIs range from fatigue and diarrhea to life threatening immune-related adverse events. Pneumonitis is a rare but serious side effect of this class of medications occurring in around 2-5% of patients in clinical trials. However, more recent retrospective studies describe immune checkpoint inhibitor pneumonitis (ICIP) rates upward of 19%. The median onset of ICIP is reported to be 2.3 months but can occur up to 27.4 months after starting ICIs. Combination ICI therapy is also associated with increased pneumonitis rates and a shorter time to ICIP onset. Patients with history of pulmonary infections are considered at a high risk for ICIP however, the impact of COVID-19 on ICIP is not well understood. The difference in ICIP rates observed between clinical trials and real-world data highlights a knowledge gap in understanding the potential factors that might influence ICIP rates, including the impact of COVID-19 infection.

Objective: This study will examine the relationship between COVID-19 infection and ICIP.

Methods: A retrospective case-control study will be conducted in adult patients who received ICIs from May 1st 2020 to September 30th 2023 within Mayo Clinic. Patients with ICIP (cases) will be matched with patients without ICIP (controls) and the medical record will be used to identify COVID-19 infection.

Conclusion: The findings of this study will help determine the association between pneumonitis and COVID-19. Mortality rates and risk factors that are associated with ICIP in patients with COVID-19 infection will also be assessed. The results may provide further guidance for ICI prescribing and risk of adverse events.

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