Javier Arístegui Fernández

Hospitalizaciones infantiles asociadas a infección por virus de la gripe en 6 ciudades de España (2014-2016)

INTRODUCTION There are only a limited number of studies on the impact of influenza in the Spanish child population. The present work intends to increase this knowledge by studying some key aspects, such as the incidence of hospital admissions, clinic variables, comorbidities, and the vaccination status in the hospitalised children. METHODS A retrospective, observational study was conducted by reviewing the medical records of children under 15 years and hospitalised due to community acquired influenza confirmed microbiologically, during 2́flu seasons (2014-2015 and 2015-2016). The study was carried out in 10 hospitals of 6cities, which represent approximately 12% of the Spanish child population. RESULTS A total of 907 children were admitted to hospital with main diagnosis of influenza infection (447 <2 years), estimating an average annual rate of hospitalisation incidence of 0.51 cases / 1,000 children (95% CI; 0.48-0.55). Just under half (45%) of the cases had an underlying disease considered a risk factor for severe influenza, and most (74%) had not been vaccinated. The percentage of children with underlying diseases increased with age, from 26% in children <6 months to 74% in children >10 years. Admission to the PICU was required in 10% (92) of the cases, mainly due to acute respiratory failure. CONCLUSION Influenza continues to be an important cause of hospitalisation in the Spanish child population. Children <6 months of age and children with underlying diseases make up the majority (> 50%) of the cases. Many of the severe forms of childhood influenza that occur today could be avoided if current vaccination guidelines were met.

CP-017 Efficacy and safety of nivolumab in a tertiary hospital: early access programme

Background Nivolumab is approved by the US Food and Drug Administration for the treatment of patients with melanoma, metastatic non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC), and has been included in our hospital’s formulary since 2015. Purpose To evaluate the efficacy and safety of patients treated with nivolumab in our hospital in real world data. Material and methods This was a retrospective observational study of all patients included in the nivolumab early access programme (November 2015–February 2016). Measured variables included: age, sex, diagnosis, disease stage, ECOG, number of cycles, prior lines of treatment, objective response and adverse effects. Evaluation of the response was performed according to RECIST version 1.1, and toxicity as defined by the NCI-CTCAE, version 4.0. Results 8 patients were included (7 men), median age 68.5 years (52–74) and ECOG 1–2. Nivolumab candidates were treated with 3 mg/kg intravenous infusions every 14 days. 6 patients were diagnosed with lung cancer (2 squamous histology, 4 adenocarcinomas) and 2 other patients had RCC. All patients had stage IV disease except one who had stage IIIA disease. They had previously received a median of two lines of treatment and the median number of cycles administered was 6. All patients with NSCLC had progressed after platinum based chemotherapy and 4 had been treated with docetaxel. Patients with RCC had received TKI therapy and everolimus previously. Regarding effectiveness, no patient obtained an objective response (complete response+partial response), 4 patients (50%) maintained stable disease (SD), 2 patients are in progression (25%) and 2 patients are awaiting evaluation by imaging but with clinical improvement. Treatment related adverse effects of any grade were reported in all patients. The most common were asthenia, respiratory infection, hyporexia, nausea and anorexia. One patient required hospitalisation with colitis grade 3. Conclusion The effectiveness in terms of objective response rate was lower than that reported in the literature. The tumour response rate was limited to SD. Treatment related adverse effects were similar to those described in other studies, mostly grades 1–2. To evaluate efficacy and long term safety, a longer monitoring period is required. It is essential to measure the health outcomes of new and expensive drugs to rationalise their use and optimise efficiency in the oncology area. References and/or acknowledgements Brahmer J, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med2015;373:123–35. No conflict of interest