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COVID-19 and NSCLC: Adapted Versus Standard Dose Schedule for Immunotherapies

By: Cordi Craig, MS
Posted: Tuesday, October 19, 2021

To reduce in-person patient contact and decrease the risk of exposure to the COVID-19 virus, Lucie Brigitte Marie Hijmering-Kappelle, MSc, of the University of Groningen, the Netherlands, and colleagues adapted the dosing schedules of nivolumab and pembrolizumab monotherapy and consolidation therapy or adjuvant durvalumab for patients with non–small cell lung cancer (NSCLC). The results of this single-center study, presented during the International Association for the Study of Lung Cancer (IASLC) 2021 World Conference on Lung Cancer (Abstract OA01.03), suggested that immune checkpoint inhibitor dose adaptation may be a safe strategy to decrease the number of visits to the oncology unit during the pandemic.

The study authors retrospectively analyzed data from patients with stage III or IV NSCLC. The patients with stage III disease received dose-adapted immune checkpoint inhibitor consolidation therapy and patients with stage IV disease received dose-adapted monotherapy or consolidation therapy. Dose adaptation schedules follow: Pembrolizumab monotherapy or consolidation therapy every 6 weeks at a dose of 400 mg; nivolumab every 4 weeks at a dose of 480 mg; and durvalumab every 4 weeks at a dose of 1,500 mg. The researchers compared the toxicity profiles of patients in the adapted-dose group (n = 108) with patients (n = 83) who had received standard-dose therapy prior to the pandemic.

Low-grade adverse events were observed more frequently in the adapted-dose group compared with the standard-dose group (229 events vs. 114 events, respectively). The most frequently reported adverse events included low-grade skin toxicity, fatigue, endocrinopathies, and gastrointestinal toxicities. However, during dose escalation, the study team observed no increase in toxicity between the two groups. A similar number of patients reported high-grade events in the standard-dose group (19 of 144) and the dose-adapted group (18 of 229).

Disclosure: For full disclosures of the study authors, visit library.iaslc.org.



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