Abstract 1311P
Background
The introduction of chemo-immunotherapy has improved the prognosis of patients with advanced Non-Small Cell Lung Cancer (aNSCLC). Different clinical variables and peripheral blood parameters have emerged as biomarkers in aNSCLC, but their role in aNSCLC patients receiving chemo-immunotherapy remains unclear.
Methods
We analyzed data of patients with aNSCLC treated with chemo-immunotherapy at Fondazione IRCCS Istituto Nazionale dei Tumori of Milan between April 2019 and April 2021, to evaluate the impact of age (<=65 vs >65), ECOG performance status (PS) (0-1 vs 2), number of metastatic sites (1-3 vs >3), BMI (<=25 vs >25), baseline neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) values on progression free survival (PFS) and overall survival (OS). The thresholds for NLR and MLR values were defined through the maximally selected rank statistics. The impact of these variables on PFS and OS was evaluated through Cox proportional hazard models.
Results
Among 73 aNSCLC patients included, 61 (84%) had adenocarcinoma, 7 (9%) had NSCLC-not otherwise specified (NOS), 5 (7%) had squamous cell carcinoma. Median follow up was 9.1 months. We found an association between higher NLR or MLR and lower PFS, both at univariate and multivariable analysis (aHR 6.78, 95%CI 2.05-22.41, p= 0.002 and aHR 5.98, 95%CI 2.07-17.29, p=0.001, respectively). No other variable was associated with worse PFS. Regarding OS, we found an independent association between worse PS (aHR 4.73, 95%CI 1.50-14.93, p=0.008), higher number of metastatic sites (aHR 4.30, 95%CI 1.34-13.85, p=0.015), higher MLR (aHR 4.20, 95%CI 1.18-14.90, p=0.027) and worse OS, with a trend towards worse OS for higher NLR (aHR 2.90, 95%CI 0.72-11.68, p=0.135).
Conclusions
Our data suggest an association between NLR or MLR values and prognosis in patients with aNSCLC treated with chemo-immunotherapy. If validated prospectively, these easy-to-measure biomarkers could be used, together with known prognostic clinical variables such as ECOG PS and metastatic disease burden, to predict chemo-immunotherapy efficacy in aNSCLC patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Fondazione IRCCS Istituto Nazionale dei Tumori of Milan.
Funding
Has not received any funding.
Disclosure
F.G.M. De Braud: Financial Interests, Personal, Invited Speaker: Amgen; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker: BMS; Financial Interests, Personal, Invited Speaker: Celgene; Financial Interests, Personal, Invited Speaker: Eli Lilly; Financial Interests, Personal, Invited Speaker: Ignyta; Financial Interests, Personal, Invited Speaker: Incyte; Financial Interests, Personal, Invited Speaker: Novartis; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Invited Speaker: Merck. G. Lo Russo: Financial Interests, Personal, Invited Speaker: Eli Lilly; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: Novartis; Financial Interests, Personal, Invited Speaker: AstraZeneca. All other authors have declared no conflicts of interest.