Tumori Journal Abstract Book - October 2020 - 156

156
toxicity. BAL cellular analysis showed typical and homogeneous features with predominantly macrophage elements, an
increased lymphoid population with prevalent CD8+ T
cells, and inversion of the CD4/CD8 ratio. These BAL features were associated with blood leukocytosis, hypoxemia,
normal values for procalcitonin and lactate dehydrogenase, a
cryptogenic organizing pneumonia-like (COP) radiologic
pattern. All patients recovered from pulmonary toxicity after
corticosteroid treatment for a median time of 2 months
(range 2-12). PD1 inhibitors were permanently discontinued
in 4 patients, whereas one patient was re-started on treatment
until disease progression. Interestingly, in all our patients
CIP was associated with previous or subsequent partial or
complete response.
Conclusions: Identification of a specific BAL cellular pattern allows clinicians to place this investigation in the
appropriate position of CIP diagnosis and management to
avoid considering the condition as progressive disease and
delaying proper treatment.

M07
Immune-related Bell's palsy in
melanoma patients treated with
immune checkpoint inhibitors
Cimminiello C.1, Fucà G.1, Di Guardo L.1, Beninato T.1, Patuzzo R.2,
Maurichi A.2, Gallino G.2, Mattavelli I.2, De Braud F.3, Santinami M.2,
Del Vecchio M.2
1

Unit of Melanoma Medical Oncology, Department of Medical Oncology,
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano; 2Unit of Melanoma
Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano;
3
Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei
Tumori, Milano

Background: The advent of immune checkpoint inhibitors (ICIs) was a revolution in cancer therapy, leading to
remarkable long-lasting responses in the metastatic setting
in some histotypes, especially melanoma. Together with
unprecedented clinical benefit, immunotherapy has
exposed the cancer healthcare community to novel
immune-related adverse events (irAEs), usually unpredictable and capable of involving virtually any organ or system. Here we report a retrospective analysis of patients
(pts) with melanoma who developed an immune-related,
unilateral, acute, peripheral facial nerve paralysis (Bell's
palsy) following treatment with ICIs.
Patients and methods: All consecutive pts with melanoma treated with ICIs at the Unit of Melanoma Medical
Oncology of the Fondazione IRCCS Istituto Nazionale dei
Tumori from January 2015 to January 2020 were retrospectively reviewed. Pts with a clinical diagnosis of ICIrelated Bell's palsy were identified and clinicopathological
characteristics, treatment specifics and Bell's palsy outcomes were retrieved. Descriptive statistics were used to
summarize study data.

Tumori Journal 106(2S)
Results: During the study period, a total of 5 pts developed
Bell's palsy as an irAE. Notably, all the pts were treated
within the phase III clinical trial Checkmate 238 of
nivolumab compared to ipilimumab after complete resection of stage IIIb/c or Stage IV melanoma (NCT02388906).
At time of the present report, information about study treatment was available only for one pt (ipilimumab). Median
age at the time of Bell's palsy diagnosis was 63 years (range,
48-69). 4 pts were male and one pt was female. Median
time-to-onset of Bell's palsy from ICIs initiation was 15
weeks (range, 4-39). In 3 pts the acute onset of hemifacial
weakness required ER consultation. 4 pts were treated with
prednisone alone whereas one pt was treated with prednisone plus valaciclovir. The maximum daily dose of prednisone administered was 50 mg in 4 pts and 75 mg in one pt,
whereas the median treatment duration was 36 days (range,
10-99). All the pts had a favorable outcome with a complete
regression of signs and symptoms of the facial nerve paralysis. Median time-to-recovery was 41 days (range, 10-99).
Conclusions: In melanoma patients treated with ICIs,
Bell's palsy is a rare, acute neurologic irAE with a favorable outcome following administration of oral
corticosteroids.

N - Head and Neck Tumours
N01
Selpercatinib (LOXO-292) in patients
with RET-mutant medullary
thyroid cancer
Shah M.H.1, Sherman E.J.2, Robinson B.3, Solomon B.4, Kang H.5, Lorch
J.H.6, Worden F.7, Brose M.S.8, Leboulleux S.9, Godbert Y.10, Meurer
M.11, Morris J.12, Owonikoko T.K.13, Tan D.S.14, Weiler D.15, Patel J.16,
Yang L.17, Kherani J.17, Cabanillas M.E.18, Wirth L.J.19, Locati L.O.20
1

The Ohio State University Comprehensive Cancer Center, Columbus;
Memorial Sloan Kettering Cancer Center, New York; 3Royal North Shore
Hospital, St. Leonards; 4Peter MacCallum Cancer Center, Melbourne;
5
University of California, San Francisco; 6Dana-Farber Cancer Institute,
Boston; 7University of Michigan, Ann Arbor; 8Abramson Cancer Center at the
University of Pennsylvania, Philadelphia; 9Gustave Roussy, Villejuif; 10Institut
Bergonie, Bordeaux Cedex; 11Hospital La Timone, Marseille; 12Mayo Clinic,
Rochester; 13Emory University School of Medicine, Atlanta; 14National Cancer
Centre, Singapore; 15Medical Oncology, Cantonal Hospital Lucerne, Lucerne;
16
Robert H. Lurie Comprehensive Cancer Center of Northwestern University,
Chicago; 17Loxo Oncology Inc., a wholly owned subsidiary of Eli Lilly and
Company, Stamford; 18The University of Texas MD Anderson Cancer Center,
Houston; 19Massachusetts General Hospital, Harvard Medical School,
Boston; 20Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
2

Background: Selpercatinib (LOXO-292) is a highly selective and potent small molecule RET kinase inhibitor. Here
we report an update on the efficacy and safety of selpercatinib in RET-mutant medullary thyroid cancer (MTC).
Patients and methods: Patients with RET-mutant MTC
were enrolled to the Phase 1/2 LIBRETTO-001 trial
(NCT03157128), a global, multicenter trial (16 countries,

Tumori Journal Abstract Book - October 2020

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