Abstract 217P
Background
No reliable biomarker is available for predicting worse clinical outcome in chemo-resistant urothelial carcinoma (UC) patients treated with pembrolizumab. We focused on the neutrophil-lymphocyte ratio (NLR), which is reported to be a simple index of systemic inflammation and a possible biomarker for predicting prognosis in various malignancies, including UC. Our aim was to evaluate whether a high NLR level could predict subsequent clinical outcomes in chemo-resistant UC patients treated with pembrolizumab.
Methods
We identified 74 cases treated with pembrolizumab for chemo-resistant UC between December 2017 and April 2019 at our 5 institutions. We investigated the association between NLR levels and their prognosis. We defined patients with NLR of > 3.37 as the high NLR group according to a calculation by receiver-operating curve analysis.
Results
The high NLR group consisted of 30 cases (40.5%). The 6-month progression-free survival (PFS) rate for the high NLR group was 10.0±5.5%, which was significantly lower than that for their counterpart (44.8±7.8%, p < 0.001). Multivariate Cox regression analysis revealed that elevated NLR (p < 0.001) and liver metastases (p = 0.003) were independent indicators for disease progression. Furthermore, the 6-month cancer-specific survival (CSS) rate for the high NLR group (64.5±9.1%) was significantly lower than that for their counterpart (88.8±5.3%, p = 0.004). Multivariate analysis revealed that an elevated NLR was the only independent indicator for cancer-specific death (p = 0.008). The change of NLR level before and after pembrolizumab was elevated in 46 cases. The 6-month PFS and CSS rate for the increased NLR group (17.8±6.0% and 71.9±7.3%) was significantly lower than that for their counterpart (47.0±10.6% and 90.9±6.1%, p = 0.012 and p = 0.009).
Conclusions
Elevated NLR could identify a population with a poor response to pembrolizumab treatment among chemo-resistant UC patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Koichiro Ogihara.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
164P - Multi-centered phase II trial of weekly 5-FU plus l-LV regimen as salvage line chemotherapy for oral fluorouracil resistant advanced gastric cancer (HGCSG1502)
Presenter: Yusuke Sasaki
Session: Poster display session
Resources:
Abstract
165P - Lenvatinib treatment for advanced hepatocellular carcinoma: The relationship between efficacy and safety
Presenter: Takayoshi Oikawa
Session: Poster display session
Resources:
Abstract
166P - The comparison between UGT1A1 single heterozygous and wild type regarding the clinical outcomes of fixed dose irinotecan monotherapy for advanced gastric cancer: Multicenter retrospective study
Presenter: Takahide Sasaki
Session: Poster display session
Resources:
Abstract
167P - Prognostic impact of the C-reactive protein/albumin ratio in advanced pancreatic cancer treated with GEM plus nab-PTX or FOLFIRINOX: Based on the results of a multicenter retrospective study (the NAPOLEON study)
Presenter: Akitaka Makiyama
Session: Poster display session
Resources:
Abstract
168P - A retrospective multicenter study evaluating the efficacy and safety of irinotecan in patients with advanced gastric cancer: Analysis of Glasgow Prognostic Score (GPS)
Presenter: Takuya Honda
Session: Poster display session
Resources:
Abstract
169P - M-phase phosphoprotein 8 promotes gastric cancer growth and metastasis via p53/Bcl-2 and EMT-related signalling pathways
Presenter: Yizhuo Wang
Session: Poster display session
Resources:
Abstract
170P - Surgery alone versus surgery combined with Chemotherapy: Survival patterns among patients with fibrolamellar hepatocellular carcinoma
Presenter: Yasmine Ashraf
Session: Poster display session
Resources:
Abstract
171P - The clinical value of prognostic nutritional index in patients with anastomotic leakage after minimally invasive esophagectomy
Presenter: Yan Wang
Session: Poster display session
Resources:
Abstract
172P - Preoperative neutrophil‐to‐lymphocyte ratio (NLR) predicts recurrence after surgery in patient with pancreatic neuroendocrine neoplasm (PanNEN)
Presenter: Takayuki Miura
Session: Poster display session
Resources:
Abstract
173P - Cancer stem-like phenotypes including immune surveillance and its responsible genes in induced liver cancer stem-like cells
Presenter: Ryouichi Tsunedomi
Session: Poster display session
Resources:
Abstract