Abstract 5742
Background
The advent of immune check point inhibitors (ICIs) has improved prognosis of various cancers. To better select responding patients (pts) and for a more accurate management of economic resources, biological and biochemical factors have been investigated. To date, no predictive biomarkers have been validated. The aim of this study is to identify manageable and routinely detectable parameters to use in clinical practice to select pts with higher change of response to ICIs.
Methods
271 consecutive metastatic solid tumor pts treated in our Institute from 2013 to 2017 with ICIs were evaluated for baseline LDH serum level, ECOG score, age, type of ICI, number of metastatic sites, histology and sex. A training and validation set were used to build and test models, respectively. Variables’ effects were assessed through odds ratio estimates (OR) and area under the receive operating characteristic curves (AUC), from univariate and multivariate logistic regression models. The validated estimates were used to develop an Excel algorithm to calculate probabilities of response.
Results
As best response, 55.4% of pts achieved disease control and 44.7% had progressive disease. On the training set, LDH, age and ECOG showed a significant OR (p:<.001, 0.009, 0.042, respectively) and were combined in a multivariate model with an AUC of 0.771 (95%CI: 0.701;0.842). These results were statistically validated on the validation set (AUC: 0.685, 95%CI: 0.569;0.801). By fitting the validated model on all pts, the 3 variables retained a significant OR and a satisfactory cross-validated AUC.
Conclusions
We confirm, as reported in literature, that baseline LDH serum levels are inversely associated with response probability. It’s reasonable to jointly consider age and ECOG, which give a significant contribution to model performance. The developed algorithm, once validated on an independent prospective series, might be a base to guide physicians in clinical practice to better plan ICI therapy tailored on pts characteristics.
Clinical trial identification
Legal entity responsible for the study
Fondazione IRCCS Istituto Nazionale Tumori.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2300 - AXL has a prognostic role in metastatic colorectal cancer (mCRC) and is a predictive biomarker of lack of efficacy of chemotherapy (CT) + cetuximab in RAS wild type (WT) patients (pts)
Presenter: Claudia Cardone
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
2834 - Multimodal detection of homologous recombination repair gene mutations (HRRm) in a Phase II trial of olaparib plus abiraterone in metastatic castrate resistant prostate cancer (mCRPC)
Presenter: Thomas Carr
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
3596 - Identification of a highly suppressive Treg subset associated to immunotherapy response
Presenter: Emilio Giunta
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
3705 - A Novel Framework for Evaluating Biomarker Response Relationships in Immuno-oncology (IO)
Presenter: Jeffrey Evelhoch
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
5332 - Comparison of OncoBEAM and NGS methods to detect plasma EGFR T790M mutations at progression of NSCLC
Presenter: Jessica Garcia
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
5700 - Differential expression of PD-L1 and immune biomarkers by age: Decreased expression in pediatric/AYA patients with advanced cancer
Presenter: Omid Hamid
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
966 - Potential resistance mechanisms revealed primary resistance to crizotinib in ROS1+ non-small-cell lung cancer using next generation sequencing: A multicenter study
Presenter: Quxia Zhang
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
2171 - Prevalence of CLDN18.2, HER2, and PD-L1 in Gastric Cancer Samples
Presenter: Diarmuid Moran
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
2318 - Epigenetic markers in circulating cell-free DNA for detection of early stage colorectal cancer
Presenter: Yanqun Liu
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
3625 - Detection and clearance of RET variants in plasma cell free DNA (cfDNA) from patients (pts) treated with LOXO-292
Presenter: Benjamin Besse
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract