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
Variable | Median IQR or absolute count % |
---|---|
dNLR (units) | 2.7 [1.8-4.1] |
LDH (U/L) | 267 [199-346] |
Age (years) | 67 [59-74] |
Female sex | 41 (47%) |
ECOG performance status (points) | 0 [0-1] |
Never smoker | 19 (22%) |
Tumor histology | / |
---Squamous NSCLC | 19 (22%) |
---Adenocarcinoma | 59 (68%) |
---Other | 9 (10%) |
PD-L1 expression (%) | 50 [1-80] |
Treatment line of IO agent | / |
---1st line | 36 (41%) |
---2nd line | 43 (49%) |
---3rd, 4th, or 5th line | 8 (10%) |
IO agent | / |
---Nivolumab | 49 (56%) |
---Pembrolizumab | 35 (40%) |
---Atezolizumab | 3 (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.
Resources from the same session
4692 - Immune cell biomarkers on neo-adjuvant chemo-immunotherapy treatment for resectable stage IIIA NSCLC patients
Presenter: Raquel Laza-Briviesca
Session: Poster Display session 3
Resources:
Abstract
1707 - Clinical utility of precision immunoprofiling and monitoring of the tumor microenvironment using flow cytometry and CyTOF in patients with advanced NSCLC treated with atezolizumab: results from a phase II study for biomarker analysis (EPOC1702)
Presenter: Keisuke Kirita
Session: Poster Display session 3
Resources:
Abstract
3594 - Tumor mutation burden (TMB), PD-L1, IFN-γ signaling identify subgroups of patients (pts) who benefit from durvalumab (D, anti-PDL1) or D and tremelimumab (T, anti-CTLA4) treatment in urothelial bladder cancer (UC)
Presenter: Christophe Massard
Session: Poster Display session 3
Resources:
Abstract
744 - The decrease of TMB, TNB and HLA expression are the Mechanism of Drug Resistance of NSCLC to immunosuppressive PD-1/PD-l1.
Presenter: Sheng Yu
Session: Poster Display session 3
Resources:
Abstract
2350 - Eosinophilia during treatment of immune checkpoint inhibitors (ICIs) predicts succeeding onset of immune-related adverse events (irAEs)
Presenter: Rika Kizawa
Session: Poster Display session 3
Resources:
Abstract
5930 - A transcriptomic immunologic signature predicts favorable outcome in neoadjuvant chemotherapy treated triple negative breast tumors.
Presenter: Javier Pérez-peña
Session: Poster Display session 3
Resources:
Abstract
6127 - Alterations of TMB and TCR repertoires during Chemotherapy in East Asian lung cancer patients without TKI-related driver gene mutations
Presenter: Lele Song
Session: Poster Display session 3
Resources:
Abstract
1310 - Association of SCFA in gut microbiome and clinical response in solid cancer patients treated with andi-PD-1 antibody.
Presenter: Motoo Nomura
Session: Poster Display session 3
Resources:
Abstract
2286 - Extracellular matrix and tissue derived metabolites in a liquid biopsy identifies endotypes of metastatic melanoma patients with differential response to immune checkpoint inhibitor treatment
Presenter: Nicholas Willumsen
Session: Poster Display session 3
Resources:
Abstract
4107 - Pathologic scoring of pre-treatment H&E biopsies predicts overall survival in patients with metastatic clear cell renal cell carcinoma receiving nivolumab monotherapy
Presenter: Julie Stein
Session: Poster Display session 3
Resources:
Abstract