Abstract 3272
Background
Lung Immune Prognosis Index (LIPI), based on pretreatment dNLR (neutrophils/(leucocytes-neutrophils)) and LDH, correlated with outcome after immune checkpoint inhibitors (ICI) in advanced NSCLC pts. We tested if LIPI, could have the same role in R/M SCCHN pts.
Methods
We conducted a retrospective study of 86 R/M HNSCC pts treated with ICI in our institution between Sep 2014 and Dec 2017. Complete blood cell counts and LDH were collected before ICI treatment. LIPI characterized 3 groups: good risk if dNLR < 3 and normal LDH, intermediate if dNLR > 3 or LDH > upper limit of normal (ULN), and poor if dNLR >3 and LDH >ULN. ICI benefit was analyzed according to overall survival (OS) and progression free survival (PFS).
Results
In our cohort, 65 pts (76%) were males, 61 (71%) current/former smokers, 81 (94%) had PS ≤ 1, with median age 59 years. According to the location: 19 (22%) had oral cavity carcinoma, 43 (50%) oropharynx, 11 (13%) hypopharynx and 13 (15%) larynx. HPV by immunohistochemistry was positive in 11/52 pts (10 oropharynx, 1 oral cavity). Twenty-eight (33%) pts received PD1, PDL1, or CTLA-4 inhibitors in monotherapy, and 58 (67%) in combination. The median of prior lines was 1 (0-6). The median follow-up was 8 months (m) [95% CI:7-12], median PFS 3 m [95% CI:2-4] and median OS 12 m [95% CI 8-NA]. The dNLR >3 (36%) and LDH >ULN (10%) were associated with poor OS (P = 0.005). Based on them, LIPI considered: 44 pts (51%) as good, 38 (44%) intermediate and 4 (5%) poor prognosis group. LIPI was an independent factor for OS (hazard ratio [HR 2.49, 95% CI 1.2-5.2] for intermediate LIPI and [HR 7.97, 95%CI 1.9-32.6] for poor LIPI, P = 0.005) and PFS (P = 0.004). Median OS for poor, intermediate, and good LIPI was 3.5 m [95% CI, 2- not reached (NR)], 7 m (95% CI, 5-NR), and 12 m (95% CI, 8-NR), respectively (P = 0.003).
Conclusions
High LIPI was correlated with worse ICI outcomes in R/M SCCHN pts. Further studies are warranted to confirm the prognostic impact of this score and the potential predictive role for ICI.
Clinical trial identification
Legal entity responsible for the study
Caroline Even.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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