PB0962 - Assessing the Relationship Between Thrombosis and Immune-Related Adverse Events in Patients with Lung Cancer Treated with Immune Checkpoint Inhibitor Therapy

Monday, June 26, 2023

18:30 – 19:30 ET

Room: Exhibition

Presenting Author(s)

LO

Lauren O'Loughlin, MD

Internal Medicine Resident
Beth Israel Deaconess Medical Center
Brookline, Massachusetts, United States

Co-Author(s)

DI

Daniela Arango Isaza

Internal Medicine Resident
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
LD

Laura Dodge

Assistant Professor
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
HV

Hollis Viray

Hematology/Oncology Fellow
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
AA

Aarti Asnani

Assistant Professor of Medicine, Cardiology
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
DC

Daniel B. Costa

Associate Professor of Medicine, Oncologist
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
DR

Deepa Rangachari

Assistant Professor of Medicine, Oncologist
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
Rushad Patell, MD (he/him/his)

Assistant Professor of Medicine
Beth Israel Deaconess Medical Center, Boston, MA, USA
Boston, Massachusetts, United States
Jeffrey I. Zwicker, MD

Chief of the Hematology Service
Department of Medicine, Hematology Service, Memorial Sloan Kettering Cancer Center, New York City, NY
New York, New York, United States

Background: Venous thromboembolisms (VTE) frequently occur in cancer, and immune checkpoint inhibitors (ICI) are now recognized to have significant thrombotic risk. ICI can induce inflammatory side effects known as immune-related Adverse Events (irAE). Inflammatory states and steroid use are known to be associated with an increased risk of thrombosis.

Aims: We aimed to determine the association between irAE and thrombosis or hemorrhage in patients with non-small cell lung cancer (NSCLC) treated with ICIs.

Methods: We identified patients with NSCLC treated with an ICI between 2016 and 2021 at an academic center. Outcomes included VTE and clinically relevant bleeding (CRB) (a composite of major bleeding and clinically-relevant non-major bleeds). We extracted frequency, type of irAE and steroid use for treatment of irAE. We used log-binomial regression to calculate the risk ratios (RR) and 95% confidence intervals (CI) of VTE and CRB among patients who had an irAE compared to those who did not.

Results: Of 207 patients included, 43.5% were female, average age at diagnosis was 67.6 ± 10.9 years and pembrolizumab was most frequent ICI used (79%). A total of 78 (37.7%) experienced an irAE on treatment. Thrombosis was commonly observed (20.3%, 95% CI 15.0-26.4%) and less frequently hemorrhage (8.7%, 95% CI 5.2-13.3%) (Table 1). The development of irAE was not associated with increased risk of VTE (RR: 1.17, 95% CI: 0.67-2.04, P=0.58). Similarly, among those with an irAE, steroid treatment was not associated with significantly increased odds of VTE (RR: 1.83, 95% CI: 0.75-4.47, P=0.18). The risk of CRB was not statistically higher among those with an irAE compared to those without (RR: 1.65, 95% CI: 0.68-3.97, P=0.26).

Conclusion(s): In a cohort of over 200 patients with NSCLC treated with ICI, the development of bleeding or thrombosis was not linked with the development of irAE.