Abstract 3494
Background
An elevated pre-treatment Neutrophil to Lymphocytes Ratio (NLR) is associated with poor prognosis in various malignancies. As optimal cut-off is highly variable and few data have been reported in patients treated with anti-PD-1, we investigated the association between NLR kinetics with outcomes in patients receiving anti-PD-1.
Methods
We performed a retrospective study including successive patients with mRCC and NSCLC treated with anti PD-1 N monotherapy in second-line setting or later, between March 2013 and December 2018. NLR were prospectively collected before study entry and before every nivolumab administration. Main clinical and biological characteristics were recorded including IMDC prognostic groups for mRCC cohort. We analysed associations between baseline NLR, NLR kinetics (any increase or decrease) and survival outcomes, including PFS, OS and objective response rate (ORR).
Results
161 patients (86 mRCC and 75 NSCLC) were included in our study. With a median follow-up of 25 months, median PFS and OS were respectively 4.6 and 24.7 months for mRCC cohort and 4.4 and 16.8 months for NSCLC cohort. Between the first and the fourth N administration, 55 and 45% of the overall cohort had a decreased or an increased NLR. Survival outcomes according to NLR variations between the first and the fourth N administration are summarized in the Table. In multivariate analysis, NLR increase was associated with worse PFS (HR = 2.6; p = 0.000004) and OS (HR = 2.3; p = 0.001) for the overall cohort but also for the two cohorts when analysed separately. Association between NLR kinetics and response rate, IMDC groups and adverse events in the mRCC will be presented at the meeting.Table:
1255P Survival outcomes
All patients | |||
---|---|---|---|
NLR increase | NLR decrease | p | |
PFS (months, 95% IC) | 3.7 (2.9-4.4) | 11 (9-15.3) | <0.0001 |
OS (months, 95% CI) | 18 (10.6-28.2) | 28.5 (27;4-NR) | 0.01 |
Conclusions
We report the largest multi-cohort analysis of NLR kinetic in N treated patients supporting that early NLR increase is associated with worse survival outcomes in two distinct cohort of mRCC and NSCLC patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
D. Borchiellini: Advisory / Consultancy: Bristol-Myers Squibb; Advisory / Consultancy: Pfizer; Advisory / Consultancy: Ipsen; Advisory / Consultancy: Roche; Advisory / Consultancy: MSD; Advisory / Consultancy: Janssen Cilag; Advisory / Consultancy: Sanofi; Advisory / Consultancy: Astellas. C. Thibault: Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: AstraZeneca; Advisory / Consultancy: bms; Travel / Accommodation / Expenses: Roche; Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: Sanofi; Advisory / Consultancy, Travel / Accommodation / Expenses: Janssen; Advisory / Consultancy: Astellas; Advisory / Consultancy, Travel / Accommodation / Expenses: Pfizer. P. Barthelemy: Advisory / Consultancy: Pfizer; Advisory / Consultancy: Ipsen; Advisory / Consultancy: Novartis. Y. Vano: Advisory / Consultancy, Travel / Accommodation / Expenses: Roche; Advisory / Consultancy: Ipsen; Advisory / Consultancy: Pfizer; Travel / Accommodation / Expenses: MSD; Advisory / Consultancy: Novartis; Advisory / Consultancy, Travel / Accommodation / Expenses: Bristol-Myers Squibb; Advisory / Consultancy: Merck; Travel / Accommodation / Expenses: Janssen Cilag; Advisory / Consultancy: Sanofi; Advisory / Consultancy: Astellas. All other authors have declared no conflicts of interest.
Resources from the same session
5822 - Greek nursing students experience facing death in clinical practice
Presenter: Maria Dimoula
Session: Poster Display session 3
Resources:
Abstract
2866 - HOPEVOL: Hospice care appropriate to the wishes and needs of patients in the palliative terminal phase.
Presenter: Merel van Klinken
Session: Poster Display session 3
Resources:
Abstract
829 - Mindfulness-based stress reduction in early palliative care for advanced cancer patients : an italian single-centre study. MINDEEP
Presenter: Emilia Gianotti
Session: Poster Display session 3
Resources:
Abstract
2702 - Optimising Inpatient Oncology Care
Presenter: Lisa Judge
Session: Poster Display session 3
Resources:
Abstract
1527 - Analysis on the Implementation Results of Family Sickbed for Oncology Patients in Dongshi Township Health Centers from 2015 to 2017
Presenter: Yayu Huang
Session: Poster Display session 3
Resources:
Abstract
2054 - Exploring needs for palliative care and quality of life for oncology patients with advanced disease who undergo radiotherapy
Presenter: Foteini Antonopoulou
Session: Poster Display session 3
Resources:
Abstract
5605 - Cytotoxic contamination in cancer care settings – Risks and safety awareness among cancer nurses
Presenter: Sandra Lundman Vikberg
Session: Poster Display session 3
Resources:
Abstract
5769 - Understanding Chemotherapy - group education sessions prior to commencing chemotherapy
Presenter: Aileen McHale
Session: Poster Display session 3
Resources:
Abstract
2620 - Estimation of HPQ-based absenteeism and presenteeism in cancer patients via ResearchKit
Presenter: Shunsuke Kondo
Session: Poster Display session 3
Resources:
Abstract
4705 - Identifying falls-related variables and risk factors in hospitalised cancer patients
Presenter: Maria Montserrat Martí Dillet
Session: Poster Display session 3
Resources:
Abstract