193 Background: CIPN has a known negative impact on quality of life (QoL) and can be a dose-limiting side effect of cytotoxic drugs with no generally agreed upon therapeutic intervention. In this study MT was assessed as a primary and secondary preventive modality of CIPN symptoms under the hypothesis that it can be used as an effective prophylactic and therapeutic option. Methods: A single arm 10-week prospective study (n = 62) with pre/post intervention assessment using a validated survey instrument adapted from “Peripheral neuropathy associated with novel therapies […]”. (Clin J Onc Nur. 2008; (12)3:9-12) Results: 97% (60/62) had at least 2 CIPN-related symptoms. (Table 1) After a single MT session, at least 50% of pts (range 52-100%) reported improvement in all CIPN-related symptom categories. These observations were maintained until 2nd MT session except for vestibulocochlear related symptoms. Initially, 25/60 were on analgesics. Of these, 14 (56%) had no progression of symptoms after 1st MT session. 13/25 presented for 2nd session. 5/13 (38%) reported no progression, 4/13 (31%) reported complete resolution of symptoms and 4/13 (31%) had progression. Conclusions: With the exception of vestibulocochlear symptoms associated with CIPN, study participants reported 50% or greater improvement, which was maintained after 1st MT session. The data suggests that pts on analgesics may also benefit from MT as at least 66% (17/25) reported lack of progression or resolution of symptoms after MT intervention. Consideration for an MT-inclusive treatment strategy is supported by this study. [Table: see text]
e15146 Background: Nivolumab, a PD-1 immune checkpoint inhibitor, is being widely utilized in a number of cancers as a single agent. Adverse events, including those that are immune mediated, have been reported that resulted in discontinuation of the drug. We conducted a meta-analysis of published clinical trials to further investigate the tolerability of nivolumab in cancer patients. Methods: Databases, including PubMed and abstracts presented at American Society of Clinical Oncology annual meetings from 2015 to December 2019 were searched to identify relevant studies. This included randomized controlled trials and single arm trials that reported a discontinuation rate due to adverse events. Incidences and relative risks were calculated based on the heterogeneity of included studies. Results: Seventeen studies published between 2015 and 2019 were selected, which included a total of 4216 patients. Overall, the discontinuation rate of nivolumab due to adverse events was 6.7% (95% CI 4.7-9.5%). The rate varied significantly with the type of cancer (p < 0.001). The lowest discontinuation rate was in NSCLC of 2.1% (95% CI 1.3-2.3%), and the highest discontinuation rate was in melanoma of 15.2% (95% CI 6.8-30.6%). In addition, significantly higher intolerability is associated with the fixed dose of nivolumab at 240 mg than 3 mg/kg (P = 0.004). In comparison with chemotherapy controls, the intolerability in the nivolumab group was not significantly different, with a relative risk of 0.97 (95% CI: 0.36-2.6). Conclusions: The intolerability of nivolumab as monotherapy may be similar to chemotherapy, and can be improved with dose adjustment.
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