Abstract 337P
Background
Hyperprogressive disease (HPD) has been reported as one of unfavorable responses during treatment with immunecheck point inhibitors for advanced non-small cell lung cancer (NSCLC) patients. However its mechanism remains unclear and the phenomenon itself remains controversial.
Methods
Medical records from consecutive NSCLC patients treated by monotherapy with anti-PD-1/PD-L1 antibodies at Hyogo College of Medicine Hospital between Jun 2016 and May 2018 were analyzed retrospectively. HPD criteria was defined as 1) time to treatment failure < 1 month and 2) tumor growth kinetics rate > 2. To explore the predictive factor for HPD, we examined the association between clinical parameters and responses.
Results
Ninety-four patients were treated with nivolumab. The median patient age was 70 (range 4188) years and 72 patients (73%) were male. Patients number of ECOG PS 0/1/2/3/4 were 15(16%)/59(60%)/18(19%)/2 (3%)/0 respectively. Fifty-two patients (55%) were diagnosed with adenocarcinoma, 38 (40%) were squamous cell carcinoma, and 4 (5%) were other types. We examined Neutrophil-to-lymphocyte ratio (NLR) at base line and relative change in the course of treatment, and the NLR of 48 (56%) patients were ≥ 3.0 and the other 46 (44%) were < 3.0. Among 94 patients, the best all over response were complete response 3 (3.2%), partial response 27 (28.7%), stable disease 35 (37.2%), progressive disease 25 (26.6%); non-HPD 21 (22.3%), HPD 4 (4.3%), and not evaluated 3 (3.2%). All of the 4 HPD patients were male with ECOG PS 1/2/2/3, and treated in 2nd-line therapy for adenocarcinoma. NLR for HPD patients at baseline were 1.62, 4.84, 9.31, 14.75 (median=2.80, range 0.62-19.9) and ΔNLR (relative change of NLR in the course) were 1.51, 3.44, 3.29, 4.26 (median=1.10, range 0.27-4.26).
Conclusions
Our study suggests that HPD exists in a fraction of patients treated immune checkpoint inhibitor and could be associated with high neutrophil-to-lymphocyte ratio. We will update and publish the data containing patients treated with other anti-PD-1/PD-L1 antibodies.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
T. Minami: Honoraria (institution): Taiho. T. Yokoi: Honoraria (institution): Ono; Honoraria (institution): Chugai; Honoraria (institution): MSD; Honoraria (institution): Bristol-Myeres; Honoraria (institution): AstraZeneca; Honoraria (institution): Taiho. K. Kuribayashi: Honoraria (institution): Ono; Honoraria (institution): Bristol-Myers Squibb. T. Kijima: Honoraria (institution), Speaker Bureau / Expert testimony, Research grant / Funding (self): Ono; Honoraria (institution), Speaker Bureau / Expert testimony, Research grant / Funding (institution): Bristol-Myeres; Honoraria (institution), Speaker Bureau / Expert testimony, Research grant / Funding (institution): Chugai; Honoraria (institution), Speaker Bureau / Expert testimony, Research grant / Funding (institution): MSD; Honoraria (institution), Speaker Bureau / Expert testimony, Research grant / Funding (institution): Taiho. All other authors have declared no conflicts of interest.
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