5PSQ-226 Analysis of high alert medication prescriptions in a nursing home

Abstract

Results 13 patients were included, 76.9% men, mean age 60.4 ±8.8 years. Among the four patients with tumour samples that were evaluated for PD-L1 expression, 75% had a score !1. Three patients were treated with at least one previous line. Previous treatments were: sunitinib (n=3) cabozantinib (n=1) or nivolumab (n=1). IMDC risk classification: 7.7% favourable, 53.8% intermediate and 38.5% poor risk. Presence of metastases: lung (7/13), bone (5/13), liver (3/13), ganglionar (2/13), cerebral (1/13) and unknown (2/13). All patients were treated with pembrolizumab 200 mg every 3 weeks and axitinib 5 mg twice daily until progression, unacceptable toxicity or death. Mean duration of treatment was 28.7 weeks. 46% are continuing with active treatment. Discontinuation causes included: death (n=3), adverse effects (n=3) and progression (n=1). Toxicities included: asthenia grade (G)1-3 (n=11), anorexia G1-2 (n=6), diarrhoea G1-4 (n=5), liver profile alterations G1-3 (n=3), hyperthyroidism G1-3 (n=3), abdominal pain G1-2 (n=3), palmar-plantar erythrodysesthesia G2-3 (n=2), pruritus G1 (n=1), dizziness and paraesthesia G1 (n=1), vomiting G1 (n=1), thrombopenia G2 (n=1) and arthralgias G1 (n=1). Best TAC responses obtained were: 50% stable disease, 25% partial response and 12.5% progressive disease. In five patients the response rate was not evaluated. Conclusion and relevance Effectiveness in our patients resulted in a higher objective response rate than that in the KEYNOTE -426 trial. The combination treatment was well tolerated. To rationalise the use of novel medicines and optimise efficiency, measuring health results is crucial.