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
4370 - Continental differences in pathologic response with neoadjuvant ipilimumab (IPI) plus nivolumab (NIVO) in patients with macroscopic stage III melanoma in the phase 2 OpACIN-neo trial.
Presenter: Irene Reijers
Session: Poster Display session 3
Resources:
Abstract
3230 - Comparable responses of melanoma at primary site and synchronous lymph node metastases upon neoadjuvant ipilimumab (IPI) and nivolumab (NIVO)
Presenter: Judith Versluis
Session: Poster Display session 3
Resources:
Abstract
3171 - Adjuvant Therapies for Stage III Melanoma: Benchmarks for Bringing Clinical Trials to Clinical Practice
Presenter: Tina HIEKEN
Session: Poster Display session 3
Resources:
Abstract
3493 - Mixture-cure modeling for resected stage III/IV melanoma in the phase 3 CheckMate 238 trial
Presenter: Jeffrey Weber
Session: Poster Display session 3
Resources:
Abstract
3036 - An open-label, non-randomized, phase IIIb study of trametinib in combination with dabrafenib for patients with unresectable advanced BRAFV600-mutant melanoma: a subgroup analysis of patients with brain metastasis
Presenter: Caroline Dutriaux
Session: Poster Display session 3
Resources:
Abstract
2233 - Adverse event (AE) kinetics in patients (pts) treated with dabrafenib + trametinib (D + T) in the metastatic and adjuvant setting
Presenter: Jean Jacques Grob
Session: Poster Display session 3
Resources:
Abstract
2435 - A Single Arm, Open Label, Phase II, Multicenter Study to Assess the Detection of the BRAF V600 Mutation on cfDNA from Plasma in Patients with Advanced Melanoma
Presenter: Piotr Rutkowski
Session: Poster Display session 3
Resources:
Abstract
1766 - Efficacy and Safety of Dabrafenib and Trametinib in Patients with Metastatic BRAFV600 Mutation-positive Melanoma in the Real-World Setting – Interim results of the non-interventional COMBI-r study
Presenter: Carola Berking
Session: Poster Display session 3
Resources:
Abstract
2131 - Trial update: A randomized Phase Ib/II study of the selective small molecule Axl inhibitor Bemcentinib (BGB324) in combination with either dabrafenib/trametinib (D/T) or pembrolizumab in patients with metastatic melanoma
Presenter: Oddbjørn Straume
Session: Poster Display session 3
Resources:
Abstract
4074 - Analysis of pyrexia in patients (pts) treated with dabrafenib (D) and/or trametinib (T) across clinical trials
Presenter: Caroline Robert
Session: Poster Display session 3
Resources:
Abstract