Abstract 3639
Background
Derived neutrophils/(leukocytes-neutrophils) ratio (dNLR) and lactate dehydrogenase (LDH) level have been correlated with immune checkpoint inhibitors (ICI) outcomes. A lung immune prognostic index (LIPI) that showed association with ICI outcomes was developed by Mezquita L et al. based on these 2 systemic inflammation indicators (dNLR <3 and LDH > upper limit of normal (ULN)), characterizing 3 prognostic groups: good, 0 factors; intermediate, 1 factor; poor, 2 factors. This index hasn’t been specifically studied in first-line setting of NSCLC with pembrolizumab monotherapy.
Methods
This is a multicenter retrospective study to explore the prognostic value of LIPI score in treatment-naïve advanced NSCLC with high PD-L1 expression ( > =50%) treated with pembrolizumab. Consecutive patients treated in 19 Spanish hospitals between March 2015 and April 2019 were included. Pretreatment LIPI score was calculated for all subjects and primary endpoint was OS.
Results
223 patients were included. Mean age 67 years (SD 9.8). 77.6% were male and 75% PS < =1. Predominant histologies: adenocarcinoma (65%), squamous-cell carcinoma (26%). Median number of cycles: 7 (IQR:1-33). 30.3% were LIPI 0 (good prognosis), 42.4% LIPI 1 (intermediate prognosis), and 27.3% LIPI 2 (poor prognosis). Disease control rate (DCR) was 65,6%. In Kaplan-Meier analysis, median OS for good, intermediate, and poor groups was 15,1m (95% CI, 13-17,1), 21,7m (95% CI, 18,8-24,5) and 9,3m (95% CI, 7-11,7) (p < 0.001). Worse PFS was observed in LIPI2 but was not statistically significant (p = 0.064). There were not OS or PFS differences between LIPI 0 and 1, but a LIPI score of 2 was independently associated with poorer OS (unadjusted HR: 3.7; 95% CI:1.89-7.5 , p < 0.001); and HR adjusted by gender, sex, number of metastatic locations, basal haemoglobin, corticoids use and PS score: 2.3;95% CI: 1.3-3.9, p = 0,002). LIPI 2 group patients had also worse DCR (45% vs 64% in LIPI0 and 74% in LIPI1, p = 0.012).
Conclusions
LIPI score was able to define a group of patients with poor benefit from pembrolizumab monotherapy in such a selected population (advanced NSCLC with high PD-L1 expression) with high probability to get benefit from it according to KN-024.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5344 - Global trends in population-based survival for 303,169 adults diagnosed with glioblastoma in 44 countries during 2000-2014 (CONCORD-3)
Presenter: Fabio Girardi
Session: Poster Display session 1
Resources:
Abstract
3088 - Spanish Survey of treatment recommendations for elderley patients with glioblastoma
Presenter: María Ángeles Vaz Salgado
Session: Poster Display session 1
Resources:
Abstract
3484 - Updated analysis of the National Registry of Nervous System Tumors in Spain (RETSINE). RETSINE: National Registry of Nervous System Tumors of the Spanish Research Group in Neuro-oncology (GEINO) and Spanish Infrequent and Orphan Tumors Group (GETHI)
Presenter: Isaac Ceballos Lenza
Session: Poster Display session 1
Resources:
Abstract
4737 - Development and validation of novel nomograms predicting survival of malignant ependymoma patients: A population-based study
Presenter: Alzhraa Abbas
Session: Poster Display session 1
Resources:
Abstract
4740 - Characteristics, incidence, and survival of primary cerebral lymphoma: A population based study
Presenter: Sherief Ghozy
Session: Poster Display session 1
Resources:
Abstract
5362 - Trends in Incidence and Survival Analyses of Adult-onset Medulloblastoma
Presenter: Feifei Lin
Session: Poster Display session 1
Resources:
Abstract
3868 - Meta of classical chemotherapy compared with high-dose chemotherapy combined with autologous stem cell transplantation in newly diagnosed medulloblastoma patients after radiotherapy
Presenter: Mengting Zhang
Session: Poster Display session 1
Resources:
Abstract
4446 - Effect of cumulative dose of maintenance temozolomide on overall survival in patients with high grade glia tumors: a single institution analysis
Presenter: Marta Nerone
Session: Poster Display session 1
Resources:
Abstract
5119 - Markers of systemic inflammation correlate with survival prognosis in patients with newly diagnosed brain metastases
Presenter: Angelika Starzer
Session: Poster Display session 1
Resources:
Abstract
3882 - Venous Thromboembolism and Intracranial Hemorrhage in Patients with High-grade Glioma
Presenter: Clara Borges
Session: Poster Display session 1
Resources:
Abstract