Introduction The treatment of non-small cell lung cancer (NSCLC) has profoundly changed on account of the arrival of new therapies, like immunotherapy. Within this group of drugs, those aimed at the programmed cell death-1 or programmed cell death ligand-1(PD1/PDL-1) are very relevant, for example, Pembrolizumab. Although its adverse reactions are generally mild and well tolerated, it has been associated with certain immune-related adverse events (IrAEs) than can be serious and affect any organ. Case report A 62-year-old woman diagnosed with stage IV NSCLC with a single bone metastasis and PD-L1 expression of 60% started treatment with cisplatin-pemetrexed-pembrolizumab, and maintenance with pembrolizumab. Management and outcome The patient attended the ER with pericardial effusion that was assumed to be a Pembrolizumab IrAE and was managed with corticosteroids. The patient fully recovered but immunotherapy was not reintroduced due to the severity of the AE. Discussion The cardiovascular system is among the least affected organs by immunotoxicity, with an incidence between 0.09–0.6%. However, some authors suspect the incidence is underestimated. Median time to onset is highly variable, ranging from 6 weeks since the first dose to 2 years after discontinuation of the treatment. There are not guidelines on the most effective management of the IrAEs, but according to the pharmaceutical reference, corticosteroids should be initiated followed by a progressive reduction. If no response is obtained, another immunosuppressive agent should be added. The determination to restart immunotherapy depends on the severity of the adverse reaction, the availability of other alternative treatments, and the cancer response.

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e14041 Background: Glioblastoma (GBM) is highly vascularized tumor with elevated expression of vascular endothelial growth factor (VEGF). Bevacizumab (Bz) is a humanized monoclonal antibody against VEGF, which alone or associated with chemotherapy has obtained optimal results. However, the most suitable combination with bevacizumab is yet unknown. The objective of our study is to evaluate the efficacy and safety of Bz and fotemustine (Ft) in patients (pts) with recurrent GBM of the Huelva area and to compare our results with those published in the phase II study of the Italian Association of Neuro-oncology (AINO). Methods: Observational and descriptive study of the combination of Ft-Bz in GBM at first relapse after standard radiotherapy and TMZ concomitant in the hospital area of Huelva during the years 2010-2021. We used the same therapeutic scheme of the phase II study of AINO and the IBM SPSS Statistics 22 program to analyze the variables. Results: 42 pts were treated, 16 women and 25 men. Median age 52 years. ECOG 0-1 in 85.4%. 65.9% and 92.7% received antiepileptics and corticosteroids, respectively. In 90.2%, methylation status of the promoter of O6-methylguanine-DNA methyltransferase (MGMT) was not evaluated. Previously, 56.1% of the pts underwent total/subtotal resection, 29.3% partial and 14.6% were not resected, followed by concomitant radiotherapy and temozolamide in 100% of cases. 35.7% relapsed in less than 3 months after adjuvant treatment. 61% presented unifocal relapse and 39% multifocal. 46.3% of the pts had stable disease, 24.4% partial response and 2.4% complete response. 22% presented grade 3-4 toxicity. The most frequent toxicities are listed in the table. The median progression-free survival (PFS) was 6 months (95% CI 4.18-7.82) and the median overall survival (OS) was 7 months (95% CI 4.22-9.77). Conclusions: The results obtained in our study were similar to those of other previously published studies of Bz in combination with Ft. Although PFS was slightly higher than the phase II study AINO, OS was lower, probably due to the inclusion of a high rate of rapid progressors pts. Treatment tolerance was similar to that in the phase II study AINO. An increase in hematologic adverse events stands out in our pts. Therefore, this scheme can be a valid alternative in the management of recurrent GBM.[Table: see text]

e15564 Background: TAS-102 (trifluridine - tipiracil) increases the survival of patients with metastatic colorectal cancer (mCRC) in 3rd or successive lines based on the results in overall survival (OS) of the phase 2 trial by Yoshino T et al and of the subsequent phase 3 RESOURCE and TERRA. It has a good toxicity profile, mainly at the gastrointestinal and hematological levels. Different publications relate neutropenia secondary to this drug with greater clinical benefit. Methods: Retrospective and multicenter observational study with patients diagnosed with mCRC treated with TAS-102 in the Juan Ramón Jiménez and General de Río Tinto hospitals (Huelva) between January 2016 and September 2021. We describe demographic data and other variables; subsequent Cox regression and multivariate analysis between OS and the different variables. We represent the OS median using Kaplan-Meier curves. Results: 47 patients were included. Median age 66 years; 66% men. No patient with ECOG > 2. Primary colon tumor in 55.4%; 72.3% with various metastatic locations. KRAS mutation in 63.8%. 78.8% in third line and the rest in fourth or successive. 80.9% have died. 82.9% abandoned due to progression and 8.5% due to toxicity: anemia 76.6% (grade ≥3 4.3%), neutropenia 74.5% (grade ≥3 44.7%), thrombocytopenia 10, 6% (grade ≥3 2.1%) and gastrointestinal 44.7% (grade ≥3 6.4%). The Kapplan Meier shows significant differences between the neutropenia curves 0 and grade 3-4 (median: 8 (95% CI 5.91-10.08) vs. 19 (95% CI 16.55-21.44) months; p = 0.043) and between the curves for grade 1-2 and grade 3-4 neutropenia (median: 8 (95% CI 2.9-13.09) vs. 19 (95% CI 16.55-21.44) months; p = 0.019). Cox regression identified grade 3-4 neutropenia and grade 1-2 anemia as positive predictors of OS. Multivariate analysis describes similar results (Table). Conclusions: Japanese series (Yohei Nose, et al; Katsuya Makihara, et al and T. Yoshino, et al) suggest a benefit in OS directly proportional to the degree of neutropenia found. In our study we obtain similar results, with better OS results for patients with grade 3-4 neutropenia. Therefore, we consider severe neutropenia as a possible predictor of the efficacy of TAS-102. Although our series is one of the largest published to date, we need more studies with a larger sample to obtain robust and enlightening results.[Table: see text]