Abstract 1550
Background
There is scarce data of the impact of inflammatory indexes in locally advanced NSCLC, which is a highly heterogeneous illness. Choice of therapy is complex and often, combined CRT, either concurrently or sequentially is used. We aim to determine the impact of NLR monitoring in patients with stage III NSCLC treated with CRT.
Methods
Patients with stage III NSCLC treated with CRT were identified from Jan2010 to Dec2015 in our centre. NLR (neutrophils/lymphocytes) was retrospectively collected at baseline (B) and 5-6 weeks after CRT (C). It was considered a continuous variable and categorised (low <4, high ≥4). NLR monitoring (B and C) stratified 2 groups: good (NLR remained <4 and NLR decreased ≥4 to < 4) and poor (NLR increased <4 to ≥ 4 and NLR remained ≥4). Progression-free survival (PFS) and overall survival (OS) were estimated with Kaplan-Meier method and log-rank test. Cox regression model was used for the multivariate analysis.
Results
92 patients were included; median age 65.5 years (39-83); 85.87% were male and 90.3% had ECOG 0-1. Predominant histologies: adenocarcinoma (41.3%) and squamous-cell carcinoma (56.5%). Concurrent treatment in 78.9% patients and sequential in 21.1%. Median PFS and OS were 16.23 and 30.36 months (mo), in the overall population. On the multivariate analysis, the good prognostic group had significant longer median PFS and OS than the poor group: 33.9 vs 11.1 mo (p<.001) and 48.8 vs 17.4 mo (p<.001), respectively. Higher post-treatment NLR was also associated with shorter PFS and OS.Table:
1466P
Multivariate analysis | ||||
---|---|---|---|---|
PFS | OS | |||
HR (95% CI) | p value | HR (95% CI) | p value | |
ECOG | 1.65 (0.81 – 3.38) | 0.169 | 2.55 (1.17 – 5.56) | 0.018 |
Sequiential vs. Concurrent CRT | 0.87 (0.41 – 1.81) | 0.703 | 0.87 (0.38 – 1.97) | 0.732 |
Baseline NLR | 1.01 (0.83 – 1.23) | 0.918 | 0.84 (0.66 – 1.07) | 0.158 |
Post CRT NLR (low vs high) | 1.08 (1.01 – 1.15) | 0.018 | 1.11 (1.05 – 1.19) | <0.001 |
Prognostic groups (good vs poor) | 3.00 (1.49 – 6.02) | 0.002 | 2.83 (1.30 – 6.14) | 0.009 |
Conclusions
NLR could be used as a prognostic factor in stage III NSCLC especially when considering its dynamic evolution. Our results provide the opportunity to evaluate this inexpensive and reproducible index as a prognostic or predictive biomarker in prospective studies, particularly with the novel use of anti-PD-1/L1 after CRT.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Hospital Universitario Doctor Peset.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2935 - Correlation of progression free survival-2 and overall survival in solid tumors
Presenter: Paul Mainwaring
Session: Poster Display session 1
Resources:
Abstract
2273 - High performance of serial tumor biopsies in first in human (FIH) phase I trials.
Presenter: Jun Sato
Session: Poster Display session 1
Resources:
Abstract
5933 - Response rates and lesion-level progression patterns of solid tumor patients in an academic phase 1 program: implications for tumor heterogeneity
Presenter: Christopher Chen
Session: Poster Display session 1
Resources:
Abstract
3569 - Clinical Benefit and Response Rate in Early Phase Clinical Trials: First Report from a Single-Institution Study
Presenter: Antonio Marra
Session: Poster Display session 1
Resources:
Abstract
4139 - Patient (pt) selection for immunotherapeutic early-phase clinical trials (ieCTs): a single Phase I Unit experience
Presenter: Matteo Simonelli
Session: Poster Display session 1
Resources:
Abstract
4451 - Improving patient selection for immuno-oncology phase 1 trials: an external validation of five prognostic scores at Claudius Regaud Institute of Toulouse, Oncopôle (IUCT-O).
Presenter: Ghassan Al Darazi
Session: Poster Display session 1
Resources:
Abstract
1696 - Demonstrating the Changing Trends in Phase 1 Clinical Trials
Presenter: Christina Guo
Session: Poster Display session 1
Resources:
Abstract
3202 - Participation of Women in phase 1 oncology clinical trials
Presenter: Laura Vidal
Session: Poster Display session 1
Resources:
Abstract
4518 - Predictors for early trial discontinuation of patients with cancer participating in phase I clinical trials
Presenter: Joeri Douma
Session: Poster Display session 1
Resources:
Abstract
4368 - Safety of Tumor Treating Fields delivery to the torso: Meta analysis from TTFields clinical trials
Presenter: Federica Grosso
Session: Poster Display session 1
Resources:
Abstract