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
3690 - PD-L1 expression in resected undifferentiated pleomorphic sarcoma and its clinical implications
Presenter: Kyoungmin Lee
Session: Poster Display session 1
Resources:
Abstract
2013 - PD-L1 expression as a potential therapeutic target and prognostic biomarker in well-differentiated and dedifferentiated liposarcoma.
Presenter: Heejung Chae
Session: Poster Display session 1
Resources:
Abstract
5021 - Soft tissue sarcomas express a distinct mRNA immune profile
Presenter: Viktor Grünwald
Session: Poster Display session 1
Resources:
Abstract
3029 - The molecular landscape of fusion genes in endometrial stromal sarcomas include three nosological entities with different natural history
Presenter: Mehdi Brahmi
Session: Poster Display session 1
Resources:
Abstract
3914 - Clinical validation of a novel assay for the detection of diagnostic alterations in sarcomas
Presenter: Lauren Mc Connell
Session: Poster Display session 1
Resources:
Abstract
1912 - A prospective correlative trial of personalized patient-derived xenograft (PDX) as avatars for drug therapy in patients with metastatic or recurrent soft tissue sarcomas (STS).
Presenter: Kanan Alshammari
Session: Poster Display session 1
Resources:
Abstract
5097 - Fusion of immortalized myoblasts induces genomic instability that drives tumor development and progression.
Presenter: Candice Merle
Session: Poster Display session 1
Resources:
Abstract
1383 - let-7a suppress Ewing sarcoma CSCs' malignant phenotype through forms a positive feedback regulation loop with lin28 via STAT3
Presenter: Xu Jiang
Session: Poster Display session 1
Resources:
Abstract
3386 - Myoepithelial Tumors of Soft Tissues and Extraskeletal Myxoid Chondrosarcomas feature a distinct transcriptional pattern
Presenter: Dominga Racanelli
Session: Poster Display session 1
Resources:
Abstract
1844 - In Vivo Efficacy and Enhanced Tumor Accumulation of Liposomal Vinorelbine (TLC178) in Human Sarcoma Xenograft Mice Model
Presenter: Wan-ni Yu
Session: Poster Display session 1
Resources:
Abstract