346P - Prognostic Impact of neutrophil to lymphocyte ratio (NLR) in patients (pts) with recurrent primary malignant brain tumours (PMBT) in Phase I (Ph1)...

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Central Nervous System Malignancies
Presenter Niamh Coleman
Citation Annals of Oncology (2017) 28 (suppl_5): v109-v121. 10.1093/annonc/mdx366
Authors N. Coleman1, V. Michalarea1, S. Alken1, R. Perez Lopez2, N. Tunariu2, A. Petruckevitch1, U. Banerji1, J. de Bono1, L. Welsh1, F. Saran1, J. Lopez1
  • 1Oncology, Institute of Cancer Research Royal Marsden Hospital, SM2 5PT - Sutton/GB
  • 2Radiology, The Royal Marsden NHS Foundation Trust, London/GB

Abstract

Background

The NLR is a marker of systemic inflammatory response and elevated levels have been associated with aggressive disease and poorer outcome in multiple cancers, including prostate, lung and colon cancer. In pts with GBM, elevated NLR prior to any initial therapy is predictive for worse outcomes. For pts with refractory PMBT, the role of NLR is uncertain. We aimed to assess the prognostic impact of NLR, and the impact of corticosteroids (CCS) in pts with PMBT referred for consideration of Ph1 trial.

Methods

Retrospective data were collected on treatment (tx) and tumour characteristics of pts with PMBT referred for consideration of Ph1 trial participation between 06/2004–09/2016. Survival analyses were performed using the Kaplan-Meier method, Cox proportional hazards model; chi-squared test was used to measure associations between categorical variables.

Results

100pts with advanced, refractory PMBT were referred. All pts had received at least one line of prior tx; median no. of prior systemic therapies was 2; 76% had GBM; 63% required CCS on first assessment. Use of CCS was associated with shorter disease-free survival (HR 1.93, 95% CI 1.21-3.06, p = 0.005) and shorter overall survival (OS) in both univariate (HR 2.33, 95% CI 1.44-3.77, p = 0.001,) and multivariate analysis [MVA](HR 1.84, 95% CI: 1.05-3.24, p = 0.034). Pts with NLR≥4 were more likely to require CCS compared to pts with an NLR

Conclusions

In our advanced PMBT cohort, elevated NLR≥4 remained an independent prognostic indicator for poor outcome, independent of the use of CCS. Pts with elevated NLR requiring CCS demonstrated the worst outcomes – a reminder of the potential relevance of host immunity in PMBT.

Clinical trial identification

Legal entity responsible for the study

Royal Marsden Hospital

Funding

None

Disclosure

U. Banerji: Receipt of grants/research supports: AstraZeneca, Chugai, Onyx, BTG. Receipt of honoraria or consultation fees: Astex, Karus Therapeutics, Novartis, Vernalis.

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All other authors have declared no conflicts of interest.

Disclosure

U. Banerji: Receipt of grants/research supports: AstraZeneca, Chugai, Onyx, BTG. Receipt of honoraria or consultation fees: Astex, Karus Therapeutics, Novartis, Vernalis.

All other authors have declared no conflicts of interest.