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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

3253 - Derived Neutrophil-to Lymphocyte ratio (dNLR) change between baseline and cycle 2 is correlated with benefit during Immune checkpoint inhibitors (ICI) in advanced Non-small Cell Lung Cancer (NSCLC) patients


20 Oct 2018


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


Tumour Immunology

Tumour Site


Laura Mezquita Pérez


Annals of Oncology (2018) 29 (suppl_8): viii493-viii547. 10.1093/annonc/mdy292


L. Mezquita Pérez1, K. Arbour2, E. Auclin3, D. Saravia4, H. Rizvi2, L. Hendriks5, D. Planchard6, W. Park4, E. Nadal7, J.C. Ruffinelli Rodriguez8, S. Ponce9, C. Audigier-Valette10, A.P. Marilniello11, G. Zalcman12, M. Majem13, G. Schiavone14, A.C. Dingemans15, G. Lopes16, M.D. Hellmann2, B. Besse17

Author affiliations

  • 1 Medical Oncology Department, Gustave Roussy, 94800 - Villejuif/FR
  • 2 Medical Oncology Department, Memorial Sloan Kettering Cancer Center, New York/US
  • 3 Oncology, Hopital European George Pompidou, 75015 - Paris/FR
  • 4 Medical Oncology Department, Sylvester Comprehensive Cancer Center, Miami/US
  • 5 Pulmonary Diseases, Maastricht University Medical Center (MUMC), 6202 AZ - Maastricht/NL
  • 6 Medical Oncology, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 7 Medical Oncology Department, Institut Catala de Oncologia, 08907 - Barcelona/ES
  • 8 Medical Oncology Department, Institut Català d'Oncologia Hospital Duran i Reynals, 08907 - Barcelona/ES
  • 9 Oncología Médica, Hospital Universitario 12 de Octubre, Madrid/ES
  • 10 Pneumology Department, Centre hospitalier Sainte Musse, Toulon/FR
  • 11 Department Of Oncology, University of Turin, Turin/IT
  • 12 Oncology, Hôpital Bichat, 75018 - Paris/FR
  • 13 Medical Oncology Services, Hospital De La Santa Creu I Sant Pau, Barcelona/ES
  • 14 Medical Oncology Department, University of Turin, Turin/IT
  • 15 Pulmonology, Maastricht University Medical Center (MUMC), 6202 AZ - Maastricht/NL
  • 16 Clinical Medicine, University of Miami Sylvester Comprehensive Cancer Center, 33136 - Miami/US
  • 17 Dept Of Cancer Medicine, Gustave Roussy Institut de Cancérologie, 94805 - Villejuif/FR


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Abstract 3253


Baseline dNLR is associated with ICI outcomes in advanced NSCLC; we previously reported that the early dNLR change during ICI was correlated to benefit in 292 advanced NSCLC patients. We aimed to confirm the impact of dNLR monitoring in a larger cohort.


1225 patients with advanced NSCLC treated with ICI (PD1/PDL1 +/- CTLA4) from 10 European/US centers were identified between Nov. 2012 and Mar. 2018. dNLR at baseline and before cycle 2 were retrospectively collected. dNLR was defined as neutrophils/(leucocytes-neutrophils). dNLR monitoring, combining dNLR at baseline (B) et before cycle 2 (C2) stratified the 3 groups: good (if dNLR≤3 remained low at B and C2), intermediate (if dNLR status increased ≤3 at B and >3 at C2 or decreased >3 at B and ≤3 at C2), poor (dNLR>3 at B and C2).


689 (56%) were males, 1058 (87%) smokers, 1066 (87%) with PS ≤ 1, with median age 65 years; 926 (76%) had nonsquamous; 108 were KRASm. PDL1 was known in 403/1225 (33%) and was ≥1% in 270 (67%). The median PFS and OS were 3.1m [95% CI 3-4] and 12m [10-13.7]. dNLR was >3 at B in 416 (34%) and before C2 in 417 pts (34%). At C2, the dNLR status changed in 267 pts, with 133 (11%) dNLR decreased and 134 (11%) dNLR increased. The median OS was 18.6m [16-21] for the good group when dNLR remained low (n = 675, 55%), 9.2m [8-13.9] for the intermediate when dNLR changed (n = 267, 22%) and 5m [4-6.3] for the poor group when dNLR remained high (dNLR>3, n = 283, 23%) (P < 0.0001). The median PFS was 5m [4-5.5] for the good group, 2.6m [2-4] for the intermediate and 2m [2-2.6] for the poor group (P < 0.0001). The poor group was associated with radiological disease progression (OR 2.22, CI 1.33-3.7, P = 0.002).


Baseline and 2nd cycle dNLR monitoring can early discriminate the benefit to ICI in advanced NSCLC patients on treatment. dNLR should be prospectively studied in clinical trials.

Clinical trial identification

Legal entity responsible for the study

Benjamin Besse.


Has not received any funding.

Editorial Acknowledgement


All authors have declared no conflicts of interest.Table: 1407P

Multivariate analysisProgression-free Survival (PFS)Overall Survival (OS)
HR95% CIP valueHR95% CIP value
Age >65 years0.980.79-1.210.8471.150.89-1.470.292
Gender Male0.920.72-1.180.5251.050.79-1.410.712
Smoking Former/current smoker0.560.38-0.840.0050.490.49-1.230.294
Histology Squamous1.250.98-1.600.201.330.99-1.780.16
N# line of ICI >20.880.70-1.090.2320.930.72-1.200.581
N# metastatic sites >21.561.26-1.94<0.00011.701.31-2.2<0.0001
Performance status ≥21.73.29-2.31<0.00012.051.49-2.82<0.0001
dNLR monitoring Intermediate Poor1.24 1.620.94-1.62 1.22-2.130.0031.23 2.340.89-1.70 1.72-3.18<0.0001

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