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
2066 - Second-line (2L) real-world treatment (tx) patterns and outcomes in patients (pts) with advanced/metastatic non-small cell lung cancer (NSCLC) treated with first line (1L) immuno-oncology (IO) monotherapy (mono tx)
Presenter: Denis Talbot
Session: Poster Display session 1
Resources:
Abstract
5919 - Real-world effectiveness of nivolumab monotherapy after prior systemic therapy in advanced non-small cell lung cancer (NSCLC) in the United States
Presenter: David Stenehjem
Session: Poster Display session 1
Resources:
Abstract
3368 - Pembrolizumab as first-line treatment in NSCLC with PD-L1 ≥50%: Real life results from an all-comer population
Presenter: Nikolaj Frost
Session: Poster Display session 1
Resources:
Abstract
3775 - Patients with metastatic non-small cell lung cancer without molecular alterations or PD-L1 expression in Germany. Treatment and first outcome from the prospective German Registry Platform CRISP (AIO-TRK-0315)
Presenter: Frank Griesinger
Session: Poster Display session 1
Resources:
Abstract
3926 - Impact of second-line (2L) immune checkpoint inhibitors (ICIs) on the treatment (Tx) of advanced non-small cell lung cancer (NSCLC) in a UK centre: a REAL-Oncology analysis from the I-O Optimise initiative
Presenter: Michael Snee
Session: Poster Display session 1
Resources:
Abstract
5068 - First line pembrolizumab for NSCLC with PD-L1 TPS > 50% in a first French real life cohort
Presenter: Karim Amrane
Session: Poster Display session 1
Resources:
Abstract
1182 - Interstitial lung disease induced by immune-checkpoint inhibitors correlates with prognosis of advanced non-small-cell lung cancer patients
Presenter: Teppei Sugano
Session: Poster Display session 1
Resources:
Abstract
2297 - Phase II study to evaluate the peripheral blood mononuclear cell biomarker for nivolumab efficacy on previously treated non-small cell lung cancer subjects (NEJ029B: IMMUNITY-ONE)
Presenter: Yosuke Kawashima
Session: Poster Display session 1
Resources:
Abstract
2739 - Efficacy and safety of nintedanib + docetaxel in lung adenocarcinoma patients (pts) following treatment with immune checkpoint inhibitors (ICIs): Updated results of the ongoing non-interventional study (NIS) VARGADO (NCT02392455)
Presenter: Christian Grohe
Session: Poster Display session 1
Resources:
Abstract
1357 - Upfront atezolizumab chemoimmunotherapy-associated Immune-related adverse events in patients with advanced non-small cell lung cancer
Presenter: Francis Mogollon-Duffo
Session: Poster Display session 1
Resources:
Abstract