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Poster Display session 2

5139 - Neutrophil-to-lymphocyte ratio predicts platinum sensitivity in epithelial ovarian cancer patients: a MITO24 retrospective study

Date

29 Sep 2019

Session

Poster Display session 2

Topics

Tumour Site

Ovarian Cancer

Presenters

Alberto Farolfi

Citation

Annals of Oncology (2019) 30 (suppl_5): v403-v434. 10.1093/annonc/mdz250

Authors

A. Farolfi1, E. Scarpi2, F. Greco3, A. Bergamini4, L. Longo5, S. Pignata6, C. Casanova7, V. Del Vecchio8, A. Bologna9, M. Orditura10, L. Zavallone11, J. Ventriglia6, V. Gallà2, E. Franzese12, E. Pigozzi3, V. Loizzi8, G. Giorda13, D. Giardina5, R. Cioffi4, U. De Giorgi1

Author affiliations

  • 1 Medical Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Srl - IRCCS, 47014 - Meldola/IT
  • 2 Unit Of Biostatistics And Clinical Trials, Istituto Tumori della Romagna I.R.S.T., 47014 - Meldola/IT
  • 3 Medical Oncology Unit, ULSS 9 Regione Veneto, 37045 - Legnago/IT
  • 4 Department Of Obstetrics And Gynaecology,, San Raffaele Scientific Institute, 20132 - Milano/IT
  • 5 Medical Oncology Unit, Ramazzini Hospital, 41012 - Carpi/IT
  • 6 Urology And Gynecology, Istituto Nazionale Tumori – I.R.C.C.S - Fondazione Pascale, 80131 - Napoli/IT
  • 7 Department Of Medical Oncology, Santa Maria delle Croci Hospital, 48121 - Ravenna/IT
  • 8 Gynecology Oncology Unit, Università degli Studi di Bari & IRCCS Istituto Oncologico Giovanni Paolo II^, 70124 - Bari/IT
  • 9 Medical Oncology Unit, IRCCS– Arcispedale S. Maria Nuova, 42123 - Reggio Emilia/IT
  • 10 Department Of Clinical And Experimental Medicine "f. Magrassi", Università degli Studi della Campania "Luigi Vanvitelli", 81100 - Caserta/IT
  • 11 Department Medical Oncology, Infermi Hospital, 13875 - Ponderano/IT
  • 12 Department Of Clinical And Experimental Medicine "f. Magrassi", Università degli Studi della Campania Luigi Vanvitelli, 80131 - Napoli/IT
  • 13 Department Of Gynecological Oncology, Centro di Riferimento Oncologico (CRO) IRCCS, 33081 - Aviano/IT

Resources

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Abstract 5139

Background

The prognostic value of the inflammatory indexes (eg. neutrophil-to-lymphocyte ratio, NLR; and systemic immune-inflammation index, SII) was demonstrated among patients with epithelial ovarian cancer (EOC). This study aimed to evaluate their predictive value in terms of platinum-free interval (PFI) as regard to bevacizumab treatment received.

Methods

A total of 375 EOC patients were retrospectively analyzed, 301 treated with chemotherapy alone and 74 with bevacizumab, with the decision to include this drug in the chemotherapy regimen left to the discretion of the treating physician. The correlation between NLR (defined as the ratio of neutrophil to lymphocyte count) and SII, calculated as (platelet count × neutrophil count)/lymphocyte count, and PFI were analyzed using logistic regression analyses adjusted for baseline patient characteristics. Cutoff values were determined using Receiver Operating Characteristic (ROC) analysis.

Results

In univariate analysis, patients with high NLR (≥3) and SII (≥730) had a significantly shorter PFI at 6 and 12 months in overall cohort. In multivariate analysis, only NLR was an independent predictive factor for PFI at 6 months (OR = 2.52, 95% CI 1.30–4.87, p = 0.006) and at 12 months (OR = 2.05, 95% CI 1.05–4.01, p = 0.036) in the overall population and in the chemotherapy group (OR = 2.77, 95% CI 1.38–5.56, p = 0.004; HR = 2.27, 95% CI 1.10–4.70, p = 0.027, respectively). Inflammatory indexes were not predictive for PFI in the bevacizumab group (Table).Table: 1020P

PFI at 6 monthsPFI at 12 months
N. ptsN. ptsOR (95% CI)pN. ptsN. ptsOR (95% CI)p
NLR
<3741391.00113981.00
≥380682.52 (1.30-4.87)0.006106372.05 (1.05-4.01)0.036
SII
<73052991.0076731.00
≥7301021080.74 (0.36-1.53)0.413143620.91 (0.45-1.84)0.786
CT
NLR
<3621151.0098781.00
≥369482.77 (1.38-5.56)0.00489242.27 (1.10-4.70)0.027
SII
<73041801.0063561.00
≥73090830.76 (0.35-1.67)0.498124460.84 (0.39-1.82)0.663
CT+B
NLR
<312241.0015201.00
≥311200.47 (0.04-5.15)0.53817130.75 (0.11-5.25)0.774
SII
<73011191.0013171.00
≥73012251.65 (0.13-20.56)0.69619161.78 (0.21-15.14)0.599

Conclusions

The NLR was an independent predictive factor for platinum-sensitivity in patients with EOC treated with chemotherapy. Its predictive role seems to be lost in patients treated with bevacizumab.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

MITO group.

Funding

MITO group.

Disclosure

All authors have declared no conflicts of interest.

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