Abstract 2204P
Background
Malignant pleural mesothelioma (MPM) is a rare thoracic malignancy with bad prognosis. Asbestos exposure has been described as the main risk factor with a key role in its pathogenesis. The aim of this study is to identify the impact of systemic inflammation biomarkers as clinical prognostic factors for MPM.
Methods
Patients (pts) diagnosed of MPM from 2004 to 2023 from a Medical Oncology Intercenter Unit in Malaga (Spain) were enrolled. We analyzed epidemiologic, clinical and pathological characteristics and correlated them with survival outcomes.
Results
Among the 140 pts, median age was 70 years (range 23-94), ECOG 0-1 in 76,4% (n=104), mainly males (70,7%, n=99). 95 pts (67,9%) were epithelioid subtype. Median follow up was 21,6 months (mo) (range 1-217). Median overall survival (OS) 13,5 mo (CI 95% 9,6-17,4), progression-free survival (PFS) 10,1 mo (CI 95% 7,2-13). 19 pts (13,6%) were considered for surgery. In non-resectable pts (n=121, 86,4%), age over 65, malnutrition and ECOG 2-4 at diagnosis were associated to poor OS (21,6 mo CI95% 14,4-28,8; 7,1 mo, CI95% 5,8-8,2; 4,7 mo, CI95% 3-6,5 respectively). Inflammatory biomarkers including high LDH or CRP, neutrophilia, Lung Immune Prognostic Index (LIPI) intermediate-poor, and high dNLR suggested a trend towards poor survival (9,5 mo CI 95% 3,5-15,4; 8,5 mo CI 95% 4,5-12,5; 7,1 mo CI 95% 1,5-3,9; 9,5 mo CI95% 4,5-14,4; 9,5 mo CI95% 4,8-14, respectively; p>0.5). Anemia, moderate-to-severe value of neutrophil to lymphocyte ratio (NLR≥6) and not receiving immunotherapy were significantly associated with worse prognosis. Multivariate analysis showed age and NLR value as independent prognostic factors (p<0.01).
Conclusions
Host inflammation status at diagnosis may be a subrogate biomarker of survival for MPM, even for pts not receiving immunotherapy. Modulating the immune system and inflammatory pathways appear as promising strategies for increasing effectiveness in MPM treatment. Table: 2204P
Univariate analysis | Multivariate analysis | |||||
HR | CI 95% | P | HR | CI 95% | P | |
Age ≤65 | 0,56 | 0,36-0,88 | 0,01 | 0,44 | 0,23-0,82 | 0,01 |
ECOG | 1,65 | 1,3-2,6 | 0,00 | - | - | 0,37 |
Malnutrition | 0,47 | 0,29-0,74 | 0,00 | - | - | 0,78 |
Anemia | 9,86 | 0,76-0,96 | 0,01 | - | - | 0,29 |
High C reactive protein | 1,87 | 0,77-4,52 | 0,16 | - | - | - |
Neutrophilia | 2,38 | 0,31-18,41 | 0,40 | - | - | - |
High LDH | 1,47 | 0,93-2,34 | 0,09 | - | - | - |
NLR (absent-mild vs moderate severe) | 0,5 | 0,28-0,90 | 0,02 | 0,30 | 0,14-0,61 | 0,00 |
dLNR (high vs normal) | 0,91 | 0,58-1,42 | 0,69 | - | - | - |
LIPI score (good vs intermediate-poor) | 1,47 | 0,96-2,27 | 0,07 | - | - | - |
Immunotherapy | 0,48 | 0,24-0,96 | 0,04 | - | - | 0,62 |
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2161P - Organization of hospital pharmaceutical consultations for cancer patients receiving oral anticancer drugs: A nationwide cross-sectional study
Presenter: Florian Slimano
Session: Poster session 07
2162P - Can artificial intelligence provide accurate and reliable answers to cancer patients' questions? Comparison of chatbots based on the ESMO Patient Guide about cancer pain
Presenter: Kadriye Bir Yucel
Session: Poster session 07
2163P - Supportive care in French community pharmacies: OncoPharma certification
Presenter: Jérôme Sicard
Session: Poster session 07
2164P - The impact of cancer patients’ face masks on oxygenation and Co2 retention during treatment
Presenter: Mert Sahin
Session: Poster session 07
2165P - A French overview of electronic patient-reported outcomes use in 2022
Presenter: Melina Hocine
Session: Poster session 07
2166P - Long-term consequences of SARS-CoV-2 infection in cancer patients
Presenter: Yana Debie
Session: Poster session 07
2167P - Are bone targeted agents (BTAs) still useful in times of immunotherapy? The SAKK 80/19 BTA study
Presenter: Michael Mark
Session: Poster session 07
2168P - At-home infusion of immunotherapy for patients with solid tumors: First results from a single-centre program
Presenter: Javier Marco Hernández
Session: Poster session 07
2169P - Immunotherapy-based treatment in elderly cancer patients: A real-world multicenter study
Presenter: Mengye He
Session: Poster session 07
2171P - Incidence of adverse events in patients treated with a combination of immune checkpoint blockers and chemotherapy: A real life cohort
Presenter: Layal Rached
Session: Poster session 07