ESMO Asia Congress 2022

Abstract 421P

Background

Dynamic changes in the blood-based biomarkers could be used as a prognostic biomarker in patients treated with immune checkpoint inhibitors (ICIs), although the data is limited. We evaluated the association between neutrophil-lymphocyte ratio (NLR) and early NLR changes with survival in ICI-treated patients. Additionally, we created an NLR-based compound prognostic score.

Methods

We retrospectively evaluated the data of 231 patients with advanced-stage cancer. We recorded baseline clinical characteristics, baseline NLR and fourth-week NLR changes, and survival data. Survival analyses were conducted with Kaplan-Meier and Cox regression analyses. A compound model was developed with the following parameters: Baseline NLR (<5 vs. ≥5), ECOG status (0 vs. ≥1), Charlson Comorbidity Index (CCI, <9 vs. ≥9), and fourth-week NLR change (10% or over NLR increase).

Results

In multivariable analyses, higher NLR (HR: 1.743, p=0.002), 10% or over NLR increase in the fourth week of treatment (HR: 1.807, p=0.001), higher ECOG performance score (HR: 1.552, p=0.006), higher LDH levels (HR: 1.454, p=0.017) and higher CCI (HR: 1.400, p=0.041) was associated with decreased OS. Compared to patients with the lowest scores, patients in the highest score group had significantly lower OS (HR: 7.967, 95% CI: 3.531-17.979, p<0.001) and PFS. The composite score had moderate success for survival prediction with an AUC of 0.702 (95% CI: 0.626-0.779, p<0.001).

Conclusions

We observed significantly lower survival in patients with higher baseline NLR values and increased NLR values under treatment. Additionally, our proposed model, including these parameters, had a moderate predictive power for OS.