3553 - Association of systemic inflammation with local tumor characteristics and survival in glioma patients

Background

Immunotherapy has yield only modest clinical efficacy in glioma so far. However, gliomas are characterized by a range of immune suppressive features. Here, we aimed to analyze the correlation of systemic inflammation with local tumor characteristics and overall survival in glioma patients.

Methods

Glioma patients were recruited at time of diagnosis or recurrence within the Vienna Cancer and Thrombosis Study (CATS). At study inclusion, a blood draw was performed. IDH1 mutation, PD-L1 and podoplanin in glioma were assessed via immunohistochemistry.

Results

193 glioma patients (4.7% diffuse glioma, 19.7% anaplastic glioma, 75.6% glioblastoma) were included. IDH1 mutation was present in 40/193 (20.7%) patients, PD-L1 expression was observed in 20/193 (10.4%) patients, and podoplanin positivity was found in 134/193 (69.4%) patients. IDH1 mutation was associated with higher platelet count (median: 303 vs. 232 G/L, p = 0.001) and lower neutrophil count (4.71 vs 6.55 G/L, p = 0.021) as well as lower neutrophil/lymphocyte (N/L) ratio (3.34 vs. 5.13, p = 0.016). PD-L1 was associated with higher monocyte count (0.657 vs. 0.450 G/L, p = 0.008), higher C-reactive protein (CRP) (0.43 vs. 0.1 mg/dL, p = 0.005) and higher fibrinogen (379 vs. 303 mg/dL, p = 0.001). Podoplanin was associated with higher leukocyte count (8.88 vs 7.22 G/L, p = 0.040), higher neutrophil count (6.44 vs 5.03 G/L, p = 0.048), higher N/L ratio (5.4 vs. 3.2, p = 0.006) and lower platelet count (227 vs 289 G/L, p < 0.0001). Upon multivariable adjustment for sex and age, platelet count (hazard ratio per 1 unit increase: 0.997, 95% CI [0.995-0.999], p = 0.006), leukocyte count (1.040 [1.004-1.077], p = 0.030), neutrophil count (1.043 [1.000-1-087], p = 0.049) and CRP levels (1.095 [1.010-1-187], p = 0.027) correlated with overall survival.

Conclusions

Systemic inflammation correlated with overall survival in the present glioma cohort. Furthermore, molecular glioma characteristics (IDH1 mutation, PD-L1, podoplanin) were linked to distinct systemic inflammation patterns. Clinical trials on immune modulating therapies should consider these different glioma-immune system interactions in order to potentially select patients with the highest benefit.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Medial University of Vienna.

Funding

Austrian National Bank.

Disclosure

P. Mir Seyed Nazari: Travel / Accommodation / Expenses: Bayer. M. Preusser: Research grant / Funding (self): Böhringer-Ingelheim; Research grant / Funding (self): GlaxoSmithKline; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Merck Sharp & Dome; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Roche; Honoraria (self), Advisory / Consultancy: Bristol-Myers Squibb; Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: Gerson Lehrman Group (GLG); Honoraria (self), Advisory / Consultancy: CMC Contrast; Honoraria (self), Advisory / Consultancy: GlaxoSmithKline,; Honoraria (self), Advisory / Consultancy: Mundipharma; Honoraria (self), Advisory / Consultancy: Astra; Honoraria (self), Advisory / Consultancy: Zeneca; Honoraria (self), Advisory / Consultancy: AbbVie; Honoraria (self), Advisory / Consultancy: Lilly; Honoraria (self), Advisory / Consultancy: Medahead; Honoraria (self), Advisory / Consultancy: Daiichi Sankyo. A.S. Berghoff: Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Daiichi Sankyo; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self), Research grant / Funding (institution), Travel / Accommodation / Expenses: Roche; Honoraria (self), Advisory / Consultancy: Bristol-Meyers Squibb; Travel / Accommodation / Expenses: Amgen; Travel / Accommodation / Expenses: AbbVie. All other authors have declared no conflicts of interest.