Abstract 3619
Background
The response to ICI in cervical cancer remains modest and predictive biomarkers to select patients (pts) are needed. An IPI score combining lactate dehydrogenase (LDH) level and the derived neutrophils/ (leucocytes minus neutrophils) ratio (dNLR) has been shown to correlate with ICI outcome in melanoma and lung cancer. We aimed to assess the predictive value of baseline IPI for advanced cervical cancer treated with ICI.
Methods
Pre-ICI treatment dNLR and LDH were retrospectively collected for all pts with advanced cervical cancer treated at our institution with PD1/PDL1 inhibitors (n = 48). Patients were divided into three groups: IPI-0 (normal LDH, dNLR<3), IPI-1 (LDH>upper limit or dNLR>3), and IPI-2 (LDH>upper limit and dNLR>3). The primary endpoint was overall survival (OS) and the secondary objective was progression free survival analyzed by Kaplan Meyer and log-rank (PFS).
Results
In our cohort of 48 pts, 37 (77%) had squamous histology, median age was 47 (range 21 to 76), and 46 (95%) had performance status of 0 or 1. Among the 14 pts with papilloma virus (HPV) testing, 100% were HPV+. PDL1 expression >1% was detected in 9 of 13 patients tested (69%). Most patients were previously treated with at least one line of previous systemic therapy (92%). The majority were treated in phase 1 trials (n = 37) and 25 received ICI in combination with antiangiogenic therapy or another ICI. 22 patients were IPI-0, 22 IPI-1, and 4 IPI-2. Median OS and PFS for our cohort were 14.7 and 3.4 months, respectively. Median PFS in the three groups was 4.9 months, 2.6 months and 0.6 months, respectively (p = 0.004). Median OS was 19.3, 10.4, and 0.9 for IPI 0, 1, and 2, respectively (p = 0.003). OS was 8.9 months for patients who received ICI as monotherapy, whereas OS for the combination group had not yet been reached.
Conclusions
Baseline IPI was highly correlated with ICI-treated cervical cancer pt outcomes. Pts with higher IPI had poorer survival and are likely worse candidates for ICI, particularly as monotherapy. IPI score should be considered in addition to PDL1 status before introducing ICI in patients with advanced cervical cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
F. Blanc-Durand: Speaker Bureau / Expert testimony: Janssen Cylag; Travel / Accommodation / Expenses: Pfizer. P. Pautier: Travel / Accommodation / Expenses, Officer / Board of Directors: AstraZeneca; Travel / Accommodation / Expenses, Officer / Board of Directors: Roche; Travel / Accommodation / Expenses, Officer / Board of Directors: Tesaro; Officer / Board of Directors: MSD; Officer / Board of Directors: Clovis. C. Massard: Advisory / Consultancy: Amgen; Advisory / Consultancy: Astellas; Advisory / Consultancy, Research grant / Funding (institution): AstraZeneca; Advisory / Consultancy: Bayer; Advisory / Consultancy: Beigene; Advisory / Consultancy, Research grant / Funding (institution): BMS; Advisory / Consultancy: Celgene; Advisory / Consultancy: Debiopharm; Advisory / Consultancy: Genentech; Advisory / Consultancy: Ipsen; Advisory / Consultancy, Research grant / Funding (institution): Janssen; Advisory / Consultancy, Research grant / Funding (institution): Lilly; Advisory / Consultancy, Research grant / Funding (institution): Medimmune; Advisory / Consultancy, Research grant / Funding (institution): Novartis; Advisory / Consultancy, Research grant / Funding (institution): Pfizer; Advisory / Consultancy, Research grant / Funding (institution): Roche; Advisory / Consultancy, Research grant / Funding (institution): Sanofi; Advisory / Consultancy: Orion; Research grant / Funding (institution): Boehringer; Research grant / Funding (institution): Merck. A. Leary: Advisory / Consultancy, Travel / Accommodation / Expenses, PI: Tesaro; Advisory / Consultancy, Travel / Accommodation / Expenses, PI: AstraZeneca; Advisory / Consultancy, Travel / Accommodation / Expenses, PI: Clovis; Advisory / Consultancy, PI: Gammamabs; Advisory / Consultancy, Pi: Grindstone; Advisory / Consultancy, Pi: Seattle Genetics; Advisory / Consultancy, PI: Pfizer; Advisory / Consultancy, PI: MSD; Advisory / Consultancy, PI: BMS. All other authors have declared no conflicts of interest.
Resources from the same session
3330 - Tumour-infiltrating lymphocytes and BRCA-like status in stage III breast cancer patients treated with intensified carboplatin-based chemotherapy
Presenter: Leonora De Boo
Session: Poster Display session 2
Resources:
Abstract
3971 - Unravelling the biological characteristics of MammaPrint extreme risk subgroups
Presenter: Rajith Bhaskaran
Session: Poster Display session 2
Resources:
Abstract
5871 - Residual Cancer burden as a prognostic factor in a large series of Neoadjuvant chemotherapy. Subgroup analysis per molecular surrogated subtypes
Presenter: Catalina Falo
Session: Poster Display session 2
Resources:
Abstract
5014 - Clinical validation of CanAssist Breast in a Spanish cohort
Presenter: Manjiri Bakre
Session: Poster Display session 2
Resources:
Abstract
2787 - Meta-analysis on association of pathological complete response with long-term survival outcomes in triple-negative breast cancer
Presenter: Peter A. Fasching
Session: Poster Display session 2
Resources:
Abstract
4301 - Immune infiltrate composition across intrinsic subtypes in hormone receptor (HR)+/HER2- early breast cancer (BC) enrolled in the prospective LETLOB trial
Presenter: Gaia Griguolo
Session: Poster Display session 2
Resources:
Abstract
3205 - Frequency of germline mutations in women's cancer susceptibility genes in a large cohort of Chinese breast cancer patients
Presenter: Ning Liao
Session: Poster Display session 2
Resources:
Abstract
4091 - Triple blinded Prospective Study assessing the Impact of Genomics & Artificial Intelligence Watson For Oncology (WFO) on MDT’s Decision of Adjuvant Systemic Therapy for Hormone Receptor Positive Early Breast Carcinoma-
Presenter: Somashekhar Sampige Prasannakumar
Session: Poster Display session 2
Resources:
Abstract
4359 - Prognostic significance of Progesterone Receptor levels in luminal-like Her2- early Breast Cancer patients. A retrospective single Cancer Center analysis.
Presenter: Anna Diana
Session: Poster Display session 2
Resources:
Abstract
1369 - PAM50 HER2-enriched subtype and pathological complete response in HER2-positive early breast cancer: a meta-analysis
Presenter: Francesco Schettini
Session: Poster Display session 2
Resources:
Abstract