5PSQ-086 Hospitalisations in patients with metastatic non-small-cell lung cancer receiving immunotherapy

<h3>Background and Importance</h3> The inclusion of immune checkpoint inhibitors (ICIs) in lung cancer therapy has provided clinical benefits in first-line and subsequent lines of treatment in this patient population. Although the adverse event profile of ICIs differs from chemotherapy, they still present toxicity risks. Previous studies have reported a hospitalisation incidence of over 50% in lung cancer patients, with 37% of these admissions due to treatment-related adverse effects. <h3>Aim and Objectives</h3> To determine the incidence of hospitalisation in patients with metastatic non-small-cell lung cancer (mNSCLC) receiving pembrolizumab, nivolumab, or atezolizumab as monotherapy, and to evaluate the causes and duration of these admissions. <h3>Material and Methods</h3> This observational, retrospective study included mNSCLC patients treated with ICIs from September 2015 to November 2023. Data collected included demographic variables, ECOG performance status, line of treatment, number of cycles, and hospital admissions, including their reasons and duration, recorded from the start of treatment until one month after its completion. <h3>Results</h3> A total of 174 patients were included: pembrolizumab (n=49), nivolumab (n=45), and atezolizumab (n=80). The median age in the pembrolizumab and atezolizumab groups was 68 years, and 65 years in the nivolumab group. Males accounted for 72.4% of the total population. Most patients had an ECOG status of 1 (63.8%), followed by ECOG 0 (29.3%) and ECOG 2 (6.9%). Treatment was administered as first-line therapy in 36.2% of patients, second-line in 59.8%, and third-line or beyond in 4%. The median number of treatment cycles was 4 (1–41) for pembrolizumab, 6 (1–198) for nivolumab, and 3 (1–62) for atezolizumab. In terms of hospitalisations, 47.1% of patients did not require admission, while 39.7% required one, 8.6% two, and 4.6% three or more admissions. The median duration of hospital stays was 7 (1–48) days. The most common reasons for hospitalisation were tumour progression (32.1%), followed by infectious causes (26.7%) and other reasons (26.7%). Hospitalisations related to immunotherapy toxicity accounted for 14.5%, with the most frequent adverse events being pneumonitis (42.1%), diarrhoea (26.3%), neurological causes (10.5%), metabolic disorders (10.5%), thrombocytopenia (5.3%), and myocarditis (5.3%). <h3>Conclusion and Relevance</h3> During ICI monotherapy, 53% of mNSCLC patients are hospitalised, 14.5% due to immune toxicity. Pharmacist involvement in toxicity management, dose optimisation, and patient education on warning signs is essential to improve outcomes and reduce hospitalisations. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest