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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

2976 - Neutrophil-platelet score (NPS), a predictive systemic inflammation score for PD-1 immune checkpoint inhibitors (ICI) in pretreated advanced non-small-cell lung cancer (NSCLC) patients

Date

20 Oct 2018

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

Topics

Tumour Immunology;  Translational Research

Tumour Site

Presenters

Xabier Mielgo Rubio

Citation

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

Authors

X. Mielgo Rubio1, M. Sereno Moyano2, L.E. Chara3, R. López-Castro4, J. Rubio-Martínez5, A. Velastegui6, C. Olier-Garate1, S. Falagán2, I. Gómez-Barreda3, A. Riquelme7, J. Silva-Ruiz1, J. Moreno-Rubio8, C. López3, C. Bueno7, A. Cardeña9, E. Pérez-Fernández10, M.P. Martí-Castelló11, M.J. Sotelo-Lezama7

Author affiliations

  • 1 Oncology Unit, Hospital Universitario Fundación Alcorcón, 28922 - Alcorcón (Madrid)/ES
  • 2 Medical Oncology, Hospital Infanta Sofia, 28702 - SS de Los Reyes (Madrid)/ES
  • 3 Medical Oncology, Hospital Universitario Guadalajara, Guadalajara/ES
  • 4 Medical Oncology, Hospital Universitario Clínico de Valladolid, Valladolid/ES
  • 5 Medical Oncology, Hospital Universitario Móstoles, Móstoles (Madrid)/ES
  • 6 Medical Oncology, Hospital Universitario Rey Juan Carlos, Móstoles (Madrid)/ES
  • 7 Medical Oncology, Hospital Infanta Cristina, Parla (Madrid)/ES
  • 8 Medical Oncology, Hospital Infanta Sofia, 28702 - San Sebastian De Los Reyes/ES
  • 9 Oncology, Hospital Universitario Fundación Alcorcón, 28922 - Madrid/ES
  • 10 Research Unit, Statistical Support, Hospital Universitario Fundación Alcorcón, 28922 - Alcorcón (Madrid)/ES
  • 11 Medicine, Universidad Rey Juan Carlos, 28922 - Alcorcón (Madrid)/ES
More

Resources

Abstract 2976

Background

Systemic inflammation response can be characterized by changes of peripheral blood cell amounts. Several blood cell-based scores have been found to have prognostic value in some tumors treated with ICI. Neutrophil-platelet score (NPS) is a systemic inflammation-based score characterizing 3 prognostic groups: good (0), neutrophils < =7500 and platelets < =400000; intermediate (1), neutrophils >7500 or platelets >400000; poor (2), neutrophils >7500 and platelets >400000). It has never been evaluated as prognostic biomarker in NSCLC patients treated with ICI.

Methods

This is a multicenter retrospective study with the aim to evaluate prognostic value of NPS in patients with pretreated advanced NSCLC treated with PD-1 ICI between March 2015 and April 2018. Clinical data were contributed by 7 medical centers in Spain. Primary endpoint was association of NPS with overall survival (OS).

Results

168 patients were included. Median age 65 years (39-85). 134(79,8%) were male and 121(72%) were PS > =1. Predominant histologies were adenocarcinoma (50%) and squamous-cell carcinoma (42,9%). 92,3% received nivolumab and 7,7% pembrolizumab. 2,3% had EGFR mutations, and 0,6% ALK rearrangement. PD-L1 IHC was available in 25% (<1%: 36,6%; 1-49%: 39%; > =50%: 24,4%). Median number of prior lines was 1 (1-5). Median number of cycles 11 (1-68). Median follow-up time 6,3m. Response rate (RR) was 30,4% and disease control rate (DCR) 52%. Median PFS and OS were 5,6 months (m) (3,9-7,3) and 11,4 m (9,4-13,5). According to NPS, median OS for good, intermediate, and poor prognostic groups was 11,9m (9,4-14,4), 6,8m (3,3-10,2), and 3m (1,4-4,6), respectively (p = 0,003). Higher NPS was associated with poor OS: NPS1 HR 1,73 (95%CI,1,13-2,65),p=0,01; NPS2 HR 2,89 (95%CI,1,31-6,39), p = 0,009). No significant association between NPS and PFS was found. NPS was associated with DCR, NPS2 had more patients with progression disease as best response to ICI than NPS1 and 0 (86 vs 57 vs 42%, p = 0,039).

Conclusions

NPS predicted OS and DCR in pretreated advanced NSCLC patients who received treatment with PD-1 ICI nivolumab or pembrolizumab. These results need to be validated in prospective studies.

Clinical trial identification

Legal entity responsible for the study

Xabier Mielgo Rubio.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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