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Abstract: SA-PO125

Infliximab for Treatment of Immune Adverse Events

Session Information

Category: Onconephrology

  • 1600 Onconephrology

Authors

  • Parvathareddy, Vishnupriyadevi, The University of Texas Health Science Center at Houston, Houston, Texas, United States
  • Selamet, Umut, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Sen, Aditi A., The University of Texas Health Science Center at Houston, Houston, Texas, United States
  • Abdel-Wahab, Noha, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
  • Song, Juhee, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
  • Mamlouk, Omar, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
  • Page, Valda D., The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
  • Abdelrahim, Maen, Houston Methodist, Houston, Texas, United States
  • Abudayyeh, Ala, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
Background

Immune related adverse events (irAEs) challenge the use of immune checkpoint inhibitors (ICIs). We performed a retrospective study to evaluate the use of infliximab for irAE management, and its role on irAE response, progression free survival (PFS) and overall survival (OS) with a focus on melanoma patients.

Methods

This study is a retrospective review of all cancer patients exposed to infliximab after ICI from 2004 to 2021 at MD Anderson. Overall survival was assessed using Kaplan-Meier method. Univariate and multivariate logistic regression models were used to evaluate the predictors of response to infliximab, OS and PFS at months 3, 6 and 12.

Results

We identified 185 cancer patients (93 melanoma). Median follow up was 36 months with a median time from ICI initiation to irAE of 2.4 months and from irAE to infliximab of 0.3 months. 71% of the patients responded to infliximab, 27% of the patients had no response and 1.62% had unknown response at 3 months. Among different types of irAEs, colitis was associated with response to infliximab. Patients who had acute kidney injury (AKI) within one month of infliximab were less likely to respond to infliximab at all time points. Subanalysis of melanoma patients showed similar results as the entire cohort.
Regarding tumor response in relation to infliximab: 21 were in remission before infliximab 81% continued to be in remission after infliximab. In 135 patients which were not in remission 86% continued to be the same after infliximab.
In both entire cohort and melanoma the percent of patients in remission after infliximab is higher than that of patients in remission before infliximab (p=0.002).Median OS was 29.4 months in the entire cohort and 42.3 months in melanoma cohort. In melanoma cohort, AKI prior to infliximab initiation was associated with worse survival (HR 2.131, P=0.046).

Conclusion

Our study is one of the largest retrospective analysis of infliximab use for irAE management. Patients with colitis were the best responders to infliximab. In addition, AKI within one month of infliximab was associated with worse response to infliximab. In melanoma cohort, AKI before initiation of infliximab was also associated with higher risk of death. Interestingly the percent of patients in remission after infliximab is higher than that of patients in remission before infliximab.