Abstract 5119
Background
Cancer - immune system interactions are currently in focus of oncology research as immune modulating therapies have shown remarkable activity, also in patients with brain metastases (BM). Therefore, we aimed to investigate markers of systemic inflammation and their impact on survival prognosis in a large real-life cohort of BM patients.
Methods
1250 patients with newly diagnosed BM were identified from the Vienna Brain Metastasis Registry. Systemic inflammation markers included: neutrophil-to-lymphocyte ratio (NLR), leucocyte/lymphocyte ratio (LLR), platelet/lymphocyte ratio (PLR), CRP/Albumin ratio (CRP/Alb). Median was chosen as a cut-off value.
Results
Low NLR was associated with statistically significantly longer OS compared to high NLR (9 vs. 5 months; p < 0.001; log rank). Low CRP/Alb was further associated with improved prognosis as patients with low CRP/Alb presented with a median OS of 8 compared to 4 months in patients with high CRP/Alb (p < 0.001; log rank). Low LLR and PLR were also associated with a favorable survival prognosis (p < 0.001; log rank). NLR and LLR did not show differences depending on the stage of the primary tumor at diagnosis of BM (p > 0.05; Kruskal-Wallis). CRP/Alb was highest in patients with progressive disease, followed by patients with diagnosis of BM simultaneously with primary cancer diagnosis and lowest in patients with stable disease (p = 0.004; Kruskal-Wallis). PLR was highest in patients with progressive disease, followed by patients with stable disease and lowest in patients with BM diagnosis at primary cancer diagnosis (p = 0.02; Kruskal-Wallis). In multivariate analysis with DS-GPA, NLR (HR 1.40; 95% CI:1.2-1.6; p < 0.001; cox regression model), LLR (HR 1.43; 95% CI:1.3-1.6; p < 0.001; cox regression model), CRP/Alb (HR 1.48; 95% CI:1.2-1.8; p < 0.001; cox regression model) and PLR (HR 1.23; 95% CI:1.1-1.4; p = 0.001; cox regression model) remained independent factors associated with survival prognosis after BM diagnosis.
Conclusions
Markers of systemic inflammation including NLR, LLR, CRP/Alb and PLR were associated with survival prognosis of newly diagnosed BM patients underscoring the importance of cancer – immune system interactions in patients with CNS metastatic disease.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
M. Preusser: Research grant / Funding (self): Böhringer-Ingelheim; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): GlaxoSmithKline; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Merck Sharp & Dome; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Roche; Honoraria (self), Advisory / Consultancy: Bristol-Myers Squibb; Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: Gerson Lehrman Group; Honoraria (self), Advisory / Consultancy: CMC Contrast; Honoraria (self), Advisory / Consultancy: Mundipharma; Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self), Advisory / Consultancy: AbbVie; Honoraria (self), Advisory / Consultancy: Lilly; Honoraria (self), Advisory / Consultancy: Medahead; Honoraria (self), Advisory / Consultancy: Daiichi Sankyo. A.S. Berghoff: Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Daiichi Sankyo; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self), Travel / Accommodation / Expenses: Roche; Honoraria (self), Advisory / Consultancy: Bristol-Meyers Squibb; Honoraria (self), Advisory / Consultancy: Merck; Travel / Accommodation / Expenses: Amgen; Travel / Accommodation / Expenses: AbbVie. All other authors have declared no conflicts of interest.
Resources from the same session
3887 - First Real Life Data on Durvalumab after definitive concomitant ChemoRadiotherapy (cCRT) in unresectable Stage (St) III Non-Small Cell Lung Cancer (NSCLC) in France: Analysis of 591 patients (pts) enrolled in the French cohort (c) Temporary Authorization of Use (ATU)
Presenter: Virginie Avrillon
Session: Poster Display session 1
Resources:
Abstract
682 - EGFR Inhibitor Versus Chemotherapy as Adjuvant Treatment for Locally-advanced EGFR-mutant Non-Small Cell Lung Cancer
Presenter: Peng Xie
Session: Poster Display session 1
Resources:
Abstract
2509 - Afatinib in EGFR TKI-naïve patients with EGFR mutation-positive (EGFRm+) NSCLC: interim analysis of a Phase IIIb, multi-national, open-label study
Presenter: Filippo de Marinis
Session: Poster Display session 1
Resources:
Abstract
3300 - First-line ceritinib versus chemotherapy in patients (pts) with advanced ALK rearranged (ALK+) non-small cell lung cancer (NSCLC): ASCEND-4 Asian subgroup analysis
Presenter: Daniel SW Tan
Session: Poster Display session 1
Resources:
Abstract
2653 - A combined analysis of two Phase IIIb studies of afatinib in EGFR TKI-naïve patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC
Presenter: Filippo de Marinis
Session: Poster Display session 1
Resources:
Abstract
3663 - Impact of plasma EGFR mutation fractions on response to first generation tyrosine-kinase inhibitor in treatment of naïve non-small cell lung cancer patients
Presenter: Xiaohong Wang
Session: Poster Display session 1
Resources:
Abstract
5921 - Definition of an afatinib trough concentration threshold in the treatment of NSCLC
Presenter: Stephane Bouchet
Session: Poster Display session 1
Resources:
Abstract
2852 - A Phase Ib Trial of Neoadjuvant Chemoradiotherapy and Durvalumab(MEDI4736) for Potentially Resectable stage III Non-Small Cell Lung Cancer (NSCLC)
Presenter: Beung chul AHN
Session: Poster Display session 1
Resources:
Abstract
3273 - Low expression of Notch1 and combined Notch1/HES1 are associated with adverse survival factor for limited stage small cell lung cancer
Presenter: Jinsoo Lee
Session: Poster Display session 1
Resources:
Abstract
5141 - Mutational profiling of tumor tissue and sequential plasma illustrates emergent clones during treatment in late stage small cell lung cancer (SCLC)
Presenter: Stephanie Yaung
Session: Poster Display session 1
Resources:
Abstract