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Poster Display session 3

3628 - Predictive model for survival in advanced non-small-cell lung cancer (NSCLC) treated with frontline pembrolizumab


30 Sep 2019


Poster Display session 3



Tumour Site

Non-Small Cell Lung Cancer


Xabier Mielgo Rubio


Annals of Oncology (2019) 30 (suppl_5): v475-v532. 10.1093/annonc/mdz253


X. Mielgo Rubio1, M.E. Olmedo Garcia2, M. Sereno Moyano3, C. Aguado4, J.A. Núñez5, M. Domine Gomez6, A.M. Sánchez Peña7, I. Nalda Ariza8, S. Cerezo Gonzalez9, R. Alvarez Cabellos10, L. Cabezón Gutiérrez11, C. Pangua Mendez12, R. Cervera13, A. Calles Blanco14, R. López Castro15, J.M. Sanchez Torres16, A. Lopez Martin17, A. Velastegui Ordonez18, E. Pérez Fernández19, P. Cruz20

Author affiliations

  • 1 Medical Oncology, Hospital Universitario Fundación Alcorcón, 28922 - Alcorcon/ES
  • 2 Oncology, Hospital Universitario Ramon y Cajal, 28031 - Madrid/ES
  • 3 Medical Oncology, Hospital Infanta Sofia, 28702 - Madrid/ES
  • 4 Medical Oncology Department, Hospital Clinico Universitario San Carlos, 28040 - Madrid/ES
  • 5 Medical Oncology, Hospital Universitario 12 de Octubre, Madrid/ES
  • 6 Medical Oncology, University Hospital "Fundacion Jimenez Diaz", 28040 - Madrid/ES
  • 7 Medical Oncology, Hospital Universitario Getafe, Getafe/ES
  • 8 Medical Oncology, Hospital Universitario Guadalajara, Guadalajara/ES
  • 9 Medical Oncology, Hospital General Mancha Centro, 13600 - Alcazar de San Juan/ES
  • 10 Oncologia Medica, Hospital Virgen de la Salud, 49004 - Toledo/ES
  • 11 Medical Oncology Department, Hospital Universitario de Torrejón, 28850 - Madrid/ES
  • 12 Medical Oncology, Hospital Universitario Infanta Leonor, 28031 - Madrid/ES
  • 13 Medical Oncology, Hospital Universitario del Henares, Coslada/ES
  • 14 Medical Oncology, Hospital General Universitario Gregorio Marañon, 28007 - Madrid/ES
  • 15 Department Of Oncology, Hospital Clínico Universitario de Valladolid, Valladolid/ES
  • 16 Medical Oncology, Hospital Universitario de La Princesa, 28006 - Madrid/ES
  • 17 Medical Oncology, Hospital Universitario Severo Ochoa, 28911 - Leganes/ES
  • 18 Medical Oncology, Hospital Rey Juan Carlos, 28933 - Mostoles/ES
  • 19 Research Unit, Statistical Support, Hospital Universitario Fundación Alcorcón, Alcorcon/ES
  • 20 Medical Oncology, Hospital Universitario La Paz, Madrid/ES


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Abstract 3628


Pembrolizumab monotherapy improved overall survival (OS), progression free survival (PFS) and response rate compared to chemotherapy in patients with treatment-naïve advanced NSCLC with high PD-L1 expression ( > =50%), but we see in daily clinical practice that not all patients in this subgroup benefit equally. Prognostic and predictive factors and tools are needed.


Multicentric retrospective review of advanced NSCLC patients with high PD-L1 treated with frontline pembrolizumab from March 2015 to April 2019 was performed in 19 Spanish hospitals. We analyzed the prognostic value of different clinical variables and Lung Immune Prognostic Index (LIPI), and selected those who were prognostic in the univariate analysis. Multivariate Cox regression models were adjusted to evaluate the adequacy of models, C-index was used (values over 0.7 indicate a good model, and values over 0.8 indicate a strong model.


223 patients were included. Mean age 67 years (SD 9.8). 77.6% were male and 75% PS < =1. Predominant histologies: adenocarcinoma (65%), squamous-cell carcinoma (26%). Median PFS was 12.8 months (CI95%;9.8-15.9). Median OS was not reached (24 month-OS 53.6%). LIPI 2 subgroup (unadjusted HR 3,77;p<0,001), female sex (HR 1,76; p = 0,034), age under 60 (HR 1,74; p = 0,039), presence of > =2 metastatic locations (HR 2,74;p<0,001), basal haemoglobin level < =12g/dl (HR 2; p = 0,005), corticoids use (HR 5,31;p<0,001) and ECOG-PS (HR 5,43;p<0,01) were included in a predictive Cox regression model, with a predictive C-index of 0.812 for OS and 0.76 for PFS, suggesting good discrimination. OS predictive model was called LIPI-FAMACE: LIPI - F(emale) A(ge) M(etastatic locations) A(nemia) C(orticoid use) E(COG).


LIPI-FAMACE model has a good capability for predicting survival in patients with advanced NSCLC and high PD-L1 expression treated with frontline pembrolizumab. This model needs prospective validation in an independent prospective cohort.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.


Has not received any funding.


All authors have declared no conflicts of interest.

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