Universität zu Köln

Leppelmann, Konstantin S., Med, Cand, Mooradian, Meghan J., Ganguli, Suvranu ORCID: 0000-0002-3426-4907, Uppot, Raul N., Yamada, Kei, Irani, Zubin, Wehrenberg-Klee, Eric P., Zubiri, Leyre, Reynolds, Kerry L., Arellano, Ronald S., Hirsch, Joshua A., Sullivan, Ryan J. and Fintelmann, Florian J. (2021). Thermal Ablation, Embolization, and Selective Internal Radiation Therapy Combined with Checkpoint Inhibitor Cancer Immunotherapy: Safety Analysis. J. Vasc. Interv. Radiol., 32 (2). S. 187 - 196. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1535-7732

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Abstract

Purpose: To describe interventional oncology therapies combined with immune checkpoint inhibitor (ICI) therapy targeting the programmed death 1 pathway in patients with different neoplasms. Materials and Methods: This was a retrospective cohort study of patients who underwent tumor-directed thermal ablation, embolization, or selective internal radiation therapy (SIRT) between January 1, 2011, and May 1, 2019, and received anti-programmed death 1/PD-L1 agents < 90 days before or < 30 days after the interventional procedure. Immune-related adverse events (irAEs) and procedural complications < 90 days after the procedure were graded according to the Common Terminology Criteria for Adverse Events version 5.0. The study included 65 eligible patients (49% female; age 63 years +/- 11.1). The most common tumors were metastatic melanoma (n = 28) and non-small cell lung cancer (NSCLC) (n = 12). Patients underwent 78 procedures (12 patients underwent > 1 procedure), most frequently SIRT (35.9%) and cryoablation (28.2%). The most common target organs were liver (46.2%), bone (24.4%), and lung (9.0%). Most patients received ICI monotherapy with pembrolizumab (n = 30), nivolumab (n = 22), and atezolizumab (n = 6); 7 patients received ipilimumab and nivolumab. Results: Seven (10.8%) patients experienced an irAE (71.4% grade 1-2), mostly affecting the skin. Median time to irAE was 33 days (interquartile range, 19-38 days). Five irAEs occurred in patients with melanoma, and no irAEs occurred in patients with NSCLC. Management required corticosteroids (n = 3) and immunotherapy discontinuation (n = 1); all irAEs resolved to grade < 1. There were 4 intraprocedural and 32 postprocedural complications (77.8% grade < 3). No grade 5 irAEs and/or procedural complications occurred. Conclusions: No unmanageable or unanticipated toxicities occurred within 90 days after interventional oncology therapies combined with ICIs.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Leppelmann, Konstantin S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Med, Cand UNSPECIFIED UNSPECIFIED UNSPECIFIED Mooradian, Meghan J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ganguli, Suvranu UNSPECIFIED orcid.org/0000-0002-3426-4907 UNSPECIFIED Uppot, Raul N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Yamada, Kei UNSPECIFIED UNSPECIFIED UNSPECIFIED Irani, Zubin UNSPECIFIED UNSPECIFIED UNSPECIFIED Wehrenberg-Klee, Eric P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zubiri, Leyre UNSPECIFIED UNSPECIFIED UNSPECIFIED Reynolds, Kerry L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Arellano, Ronald S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hirsch, Joshua A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sullivan, Ryan J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fintelmann, Florian J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-577522
DOI:	10.1016/j.jvir.2020.09.014
Journal or Publication Title:	J. Vasc. Interv. Radiol.
Volume:	32
Number:	2
Page Range:	S. 187 - 196
Date:	2021
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1535-7732
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RADIOFREQUENCY ABLATION; ADVERSE EVENTS; IMMUNE; NIVOLUMAB; RADIOEMBOLIZATION; OPPORTUNITIES; DOCETAXEL; ONCOLOGY Multiple languages Radiology, Nuclear Medicine & Medical Imaging; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57752