1602 - Predictive Value of Neutrophil-Lymphocyte Ratio (NLR) And Platelet-Lymphocyte Ratio (PLR) In Hepatocellular Carcinoma (HCC) Patients Treated with Nivolumab (N)

Background

Currently there are no recognized or validated biomarkers to identify HCC patients(pts) likely to benefit from N. Several studies have established the inverse relationship between inflammation-based scores such as NLR, PLR and survival in other solid tumours treated with immunotherapy. We evaluated the relationship between NLR and PLR and survival outcomes in HCC pts treated with N at Mount Sinai Hospital.

Methods

One hundred and four HCC pts treated between June 2016 and July 2018 were identified. NLR=Absolute neutrophil count/ Absolute lymphocyte count (ALC) and was calculated pretreatment and at 6-8 weeks after 3 doses (Posttreatment) of N. PLR=Platelet count/ALC. Kaplan-Meier analysis and the log-rank test were used to calculate and compare Overall and Progression free survival (OS, PFS) between NLR <5 vs ≥ 5 and among PLR tertiles.

Results

Median age was 66 (29-89) years. Median treatment duration was 26 (2-149) weeks. Child Pugh score (CPS, N = 96) was A in 64 (66%) and B in 32 (33%) pts. Barcelona Clinic Liver Cancer (BCLC) stage was B in 21 (20%) and C in 83 (80%) pts. Median follow-up time was 17 months (95% CI (15.7, 20.7). NLR was <5 in 64 (62%) pts pretreatment and 59 (60%) pts post treatment. NLR<5 was associated with improved OS compared to NLR≥5 both pretreatment (23 Vs 10 months, P = 0.0037) and post treatment (35 Vs 9 months, P < 0.0001). Survival also differed significantly among PLR tertiles (Table), with median OS for the lowest post treatment tertile not yet reached. Median PFS differed significantly between pre (16 Vs 5 months, P = 0.0217) and post (35 Vs 5 months, P = 0.0002) treatment NLR. PLR was not significantly associated with PFS. In a multivariable model, port treatment PLR and NLR were significantly associated with OS.Table:

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Conclusions

This study suggests that lower NLR and PLR levels may predict better survival outcomes in HCC patients treated with N. The potential role of NLR and PLR as early predictors of immunotherapy outcomes in HCC pts warrants further evaluation.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Mount Sinai Hospital.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.