1556. Infectious Disease Complications with Use of Checkpoint Inhibitors in Solid Organ Malignancies
Session: Poster Abstract Session: Viruses and Bacteria in Immunocompromised Patients
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • IDWeek Poster_Infectious Complications of Check Point Inhibitors_FINAL_jpeg.jpg (711.9 kB)
  • Background: Immune checkpoint inhibitors (ICI) are innovative cancer immunotherapies used for solid organ and hematologic malignancies. ICI are known for their immune related adverse events (irAE) but there are limited reports on infectious complications of immunosuppression for these complications. The purpose of this study was to describe the spectrum of infections in patients (pts) with melanoma, renal cell carcinoma or non-small cell lung cancer receiving ICI.

    Methods: Retrospective review of City of Hope pts with melanoma, renal cell carcinoma or non-small cell lung cancer on nivolumab, pembrolizumab, and/or ipilimumab from January to November 2017 and received 2 or more doses of ICI. Pt characteristics assessed: age, sex, prior chemotherapy, steroid use, and type of immunosuppression for irAE. Microbiology records were used to identify infections.

    Results: Thirty-nine infectious episodes (35 bacterial, 4 viral) were identified among 111 pts. Four bacteremia (2 B. cereus, coagulase-negative staphylococcus, 1 S. aureus), 12 urinary tract (10 gram negative rods, 2 gram positive cocci), 1 intra-abdominal, 8 skin and soft tissue infections (1 S. aureus,1 Actinomyces radinge, 1 E. faecalis, and 1 E. cloacae). There were 2 probable viral pneumonias (2 rhinovirus, 2 enterovirus) and no fungal infections. Fourteen (12.6%) infections were defined as serious (requiring intravenous antimicrobials and/or hospitalization). There was no association between the specific malignancy or ICI used and risk of infection. Steroid use was significantly associated with serious infections: 12/14 (85.7%) vs. 27/95 (28.4%); p=0.0003), and no pt had received infliximab or other immunosuppressant.

    Conclusion: Bacterial infections were most common, and the only risk factor associated with serious infections in our study was steroid use. Type of ICI did not impact the rate of infection.

    Kellie Komoda, PharmD1, Justine Abella Ross, PharmD2, Kim Margolin, MD2, Sumanta Pal, MD2, Jana Dickter, MD3, James Ito, MD4, Ravi Salgia, MD2 and Sanjeet Dadwal, MD2, (1)City of Hope National Medical Center, Duarte, CA, (2)City of Hope, Duarte, CA, (3)Infectious Diseases, Kaiser Permanente, Fontana, CA, (4)Division of Infectious Diseases, City of Hope, Duarte, CA

    Disclosures:

    K. Komoda, None

    J. Abella Ross, None

    K. Margolin, None

    S. Pal, None

    J. Dickter, None

    J. Ito, None

    R. Salgia, None

    S. Dadwal, Ansun Biopharma: Investigator , Research grant .

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