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
528P - High-biologically effective dose radiotherapy may improve local control of small cell lung cancer patients with brain metastases: A propensity-matching analysis
Presenter: Qingyang Zhuang
Session: Poster display session
Resources:
Abstract
530P - Prognostic value of C-reactive protein, albumin and C-reactive protein to albumin ratio in small cell lung cancer: A meta-analysis
Presenter: Carla Emille Barbon
Session: Poster display session
Resources:
Abstract
531TiP - CANOPY-A: A phase III, placebo-controlled study of canakinumab as adjuvant therapy in patients (pts) with surgically resected NSCLC
Presenter: Byoung Chul Cho
Session: Poster display session
Resources:
Abstract
532TiP - CANOPY-1: A phase III, placebo-controlled study of pembrolizumab (PEM) plus platinum-based doublet chemotherapy (Ctx) with/without canakinumab in untreated patients (pts) with stage IIIB/IIIC-IV NSCLC
Presenter: Daniel Shao Weng Tan
Session: Poster display session
Resources:
Abstract
533TiP - CANOPY-2: A phase III, placebo-controlled study of canakinumab with or without docetaxel in patients (pts) with NSCLC previously treated with PD-(L)1 inhibitors and platinum-based chemotherapy (Ctx)
Presenter: Darren Lim
Session: Poster display session
Resources:
Abstract
534TiP - A randomized phase III study of carboplatin plus nab-paclitaxel with or without nintedanib for NSCLC with IPF (J-SONIC)
Presenter: Kohei Otsubo
Session: Poster display session
Resources:
Abstract
535TiP - Phase II study of atezolizumab for pretreated advanced / recurrent non-small cell lung cancer with idiopathic interstitial pneumonia (TORG1936 / AMBITIOUS study)
Presenter: Satoshi Ikeda
Session: Poster display session
Resources:
Abstract
536TiP - INSIGHT 2: Tepotinib plus osimertinib in patients with EGFR-mutant NSCLC having acquired resistance to EGFR TKIs due to MET-amplification: A phase II trial in progress study
Presenter: James C-H Yang
Session: Poster display session
Resources:
Abstract
YO8 - Carcinosarcoma of the Breast in a Filipino Female: A Case Report
Presenter: Ma. Angelle Lalaine Dantes
Session: Poster display session
Resources:
Abstract
YO9 - Small Malignant Phyllodes Tumor of the Breast with Metastases to the Lung and Bone
Presenter: Gusti Harti
Session: Poster display session
Resources:
Abstract