Abstract 1659P
Background
Immune checkpoint inhibitors (ICIs) have greatly changed the current treatment status of extensive-stage small-cell lung cancer (ES-SCLC) and are approved to be used in the first-line setting of ES-SCLC. However. treatment choices in second line or above in ES-SCLC setting remains limited. Hence, the present retrospective study aimed to evaluate the efficacy of ICIs plus anti-VEGF/VEGFR agents in ES-SCLC patients in the second line or later setting, and preliminarily explore the predictive value of neutrophil-to-lymphocyte ratio (NLR) in ES-SCLC.
Methods
Patients with ES-SCLC who have received anti-PD-1/PD-L1-based therapy between 2019 and 2020 in the First Affiliated Hospital of Zhengzhou University were retrospectively screened. The progression-free survival (PFS), overall survival (OS), objective response rate (ORR) and disease control rate (DCR) were estimated. The correlation between NLR and the response of the combined regimen was evaluated.
Results
35 patients were ultimately included in the present study. All of them were administered with ICIs plus anti-angiogenesis agents in the second line or later setting. confirmed ORR was 17.6.0% (95%CI: 4.1%-31.1%), the DCR reached 47.1% (95%CI:29.4%-64.7%) the median PFS reached 8 months (95% CI: 3.5-12.5). At the time of data cutoff, the median OS was not reached. In univariable logistic regression analysis, patients with NLR greater than or equal to 5 were associated with poorer PFS compared with less than 5 (the median PFS 4 months vs 20.4 months, p=0.0174, HR=2.642, 95% CI: 0.94-7.4). In addition, median OS in NLR≥5 group were also significantly shorter than that in NLR < 5 group (p=0.0198, HR=8.579, 95% CI: 1.31-56.4). Additionally, the ORR was numerically higher in the NLR<5 group than that in the NLR≥5 group (21.7% [95% CI: 3.5-40] vs 8.3% [95% CI: -10-26.7], p=0.39).
Conclusions
ICIs plus anti-angiogenesis inhibitors show potential antitumor activity in second line or later settings in ED-SCLC patients. And the current work indicated NLR could be a promising predictive marker for the response of the combined regimen. The data warrant confirmation by randomized clinical studies.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
The Joint Construction Project of Henan Province and Ministry (No. LHGJ20190013).
Disclosure
All authors have declared no conflicts of interest.