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Poster Display session 3

5705 - External validation and longitudinal extension of the LIPI (Lung Immune Prognostic Index) for immunotherapy outcomes in advanced non-small cell lung cancer.

Date

30 Sep 2019

Session

Poster Display session 3

Topics

Immunotherapy

Tumour Site

Non-Small Cell Lung Cancer

Presenters

Jakob Riedl

Citation

Annals of Oncology (2019) 30 (suppl_5): v475-v532. 10.1093/annonc/mdz253

Authors

J.M. Riedl1, D.A. Barth1, V. Foris2, F. Posch3, S. Mollnar1, M. Stotz1, M. Pichler1, H. Stöger1, G. Absenger1, H. Olschewski2, A. Gerger1

Author affiliations

  • 1 Division Of Clinical Oncology, Department Of Medicine, Medical University of Graz, 8036 - Graz/AT
  • 2 Division Of Pulmonology, Department Of Medicine, Medical University of Graz, 8036 - Graz/AT
  • 3 Division Of Clinical Oncology, Department Of Medicine, Medical University of Graz, 8010 - Graz/AT

Resources

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Abstract 5705

Background

The Lung Immune Prognostic Index (LIPI), consisting of an elevated derived neutrophil-lymphocyte ratio (dNLR, 1 point for dNLR > 3 units) and an elevated lactate dehydrogenase level (LDH, 1 point for LDH > upper limit of normal) has recently been proposed as a biomarker for predicting immune checkpoint inhibitor (ICI) therapy outcomes in advanced non-small cell lung cancer (NSCLC). We sought to validate the LIPI in an external cohort, and quantify the evolution of the LIPI over time during ICI therapy.

Methods

dNLR levels, LDH levels and ICI treatment outcomes including disease control rate (DCR), 1-year progression-free survival (PFS), and 1-year overall survival (OS) were ascertained from 87 patients with advanced NSCLC who were treated with ICIs at a single academic center in Austria (Table).

Results

DCR estimates were 59%, 43%, and 32% in patients with good (0 points, n = 22), intermediate (1 point, n = 40), and poor (2 points, n = 25) LIPI risk (p = 0.171). One-year PFS estimates were 36%, 27%, and 10% (log-rank p = 0.015), and corresponding 1-year OS estimates were 53%, 52%, and 20% (log-rank p = 0.003), respectively. During ICI treatment, 1,227 LIPI measurements were available. In linear mixed modeling, the LIPI remained stable over time in the 29 patients without disease progression (average change/month=0.0 points, 95%CI: -0.1-0.0, p = 0.161), but increased over time in the 56 patients who developed disease progression (average change/month=0.02 points, 95%CI: 0.0-0.03, p = 0.004).

Conclusions

This study externally validated an elevated LIPI as a biomarker for poor ICI treatment outcomes in patients with advanced NSCLC. The LIPI increases before disease progression (Table). Continuous data are reported as medians [25th-75th percentile], and count data as absolute frequencies (%).Table:

1263P Baseline characteristics of the study population

VariableMedian IQR or absolute count %
dNLR (units)2.7 [1.8-4.1]
LDH (U/L)267 [199-346]
Age (years)67 [59-74]
Female sex41 (47%)
ECOG performance status (points)0 [0-1]
Never smoker19 (22%)
Tumor histology/
---Squamous NSCLC19 (22%)
---Adenocarcinoma59 (68%)
---Other9 (10%)
PD-L1 expression (%)50 [1-80]
Treatment line of IO agent/
---1st line36 (41%)
---2nd line43 (49%)
---3rd, 4th, or 5th line8 (10%)
IO agent/
---Nivolumab49 (56%)
---Pembrolizumab35 (40%)
---Atezolizumab3 (3%)

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.

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