Abstract 2533
Background
ICIs are pivotal therapies in the treatment of pts with R/M HNSCC. The dismal OS of some pts underscores the need to detect pre-treatment prognostic scores.
Methods
Pts with R/M HNSCC receiving pembrolizumab (P) or nivolumab (N) were included in this retrospective analysis. We analyzed the impact of the following pre-treatment variables for OS using a Cox proportional hazards regression model: drug type, age, sex, tumor site, line of therapy, p-16, albumin (alb), hemoglobin (Hb), lactic dehydrogenase (LDH), lymphocyte count (LC), platelets (PLT), and neutrophil counts (NC).
Results
66 pts (55%) treated with N and 55 (45%) with P were included. Characteristics: Sex: Male 100 pts (83%), female 21 pts (17%); Mean Age: 62 (SD 11); Performance Status 0-1: 63 pts (52%), 2-3: 58 pts (48%); Line of therapy, 1: 43 pts (36%), 2: 58 pts (48%), 3-4: 20 pts (16%); P-16: positive 44 pts (36%), negative 77 pts (64%); Tumor site: oropharynx 54 pts (45%), oral cavity 23 pts (19%), larynx 16 pts (13%), other 28 pts (23%); Response: complete 11 pts (9%), partial 3 pts (2%), stable disease 47 pts (39%); and disease progression: 60 pts (50%). The OS at 1 and 2 years were 52% (95% confidence interval (CI), 43%-62%) and 27% (CI 17%-42%), respectively. Age, sex, PLT, NC, LC, p-16, alb, Hb, and LDH were included in the multivariable Cox model. Adjusted hazard ratio estimates are: P-16: 0.53 (CI 0.3-0.95, P = 0.03); LC: 0.67 (CI 0.46-0.97, P = 0.03); NC: 1.25 (CI 1.01-1.56, P = 0.04); LDH: 1.67 (CI 1.01-2.78, P = 0.04); Hb: 1.69 (CI 1.00-2.87, P = 0.05); alb: 1.69 (CI 0.94-3.02, P = 0.08); PLT: 1.06 (CI 0.82, 1.37, P = 0.7); Age: 1.02 (CI 0.78-1.34, P = 0.9); and Sex: 0.98 (CI 0.5-1.91, P = 0.9). This model was used to create a nomogram based prognostic score for 1 and 2 year OS probability and median OS time. Internal model validation using bootstrapped based bias corrected estimates showed Nagelkerke’s R2 = 0.18, calibration slope of 0.67, and C-index of 0.7.
Conclusions
Pre-treatment LC, NC as well as LDH, Hb, alb, and p-16 had the largest impact on OS based on a prognostic nomogram. The nomogram may help treatment decisions regarding ICI use in this population.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5822 - Greek nursing students experience facing death in clinical practice
Presenter: Maria Dimoula
Session: Poster Display session 3
Resources:
Abstract
2866 - HOPEVOL: Hospice care appropriate to the wishes and needs of patients in the palliative terminal phase.
Presenter: Merel van Klinken
Session: Poster Display session 3
Resources:
Abstract
829 - Mindfulness-based stress reduction in early palliative care for advanced cancer patients : an italian single-centre study. MINDEEP
Presenter: Emilia Gianotti
Session: Poster Display session 3
Resources:
Abstract
2702 - Optimising Inpatient Oncology Care
Presenter: Lisa Judge
Session: Poster Display session 3
Resources:
Abstract
1527 - Analysis on the Implementation Results of Family Sickbed for Oncology Patients in Dongshi Township Health Centers from 2015 to 2017
Presenter: Yayu Huang
Session: Poster Display session 3
Resources:
Abstract
2054 - Exploring needs for palliative care and quality of life for oncology patients with advanced disease who undergo radiotherapy
Presenter: Foteini Antonopoulou
Session: Poster Display session 3
Resources:
Abstract
5605 - Cytotoxic contamination in cancer care settings – Risks and safety awareness among cancer nurses
Presenter: Sandra Lundman Vikberg
Session: Poster Display session 3
Resources:
Abstract
5769 - Understanding Chemotherapy - group education sessions prior to commencing chemotherapy
Presenter: Aileen McHale
Session: Poster Display session 3
Resources:
Abstract
2620 - Estimation of HPQ-based absenteeism and presenteeism in cancer patients via ResearchKit
Presenter: Shunsuke Kondo
Session: Poster Display session 3
Resources:
Abstract
4705 - Identifying falls-related variables and risk factors in hospitalised cancer patients
Presenter: Maria Montserrat Martí Dillet
Session: Poster Display session 3
Resources:
Abstract