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
2183P - The relevance of HFpEF in immunotherapy-induced myocarditis: An analysis of 65 patients
Presenter: Adam Chapman
Session: Poster session 07
2184TiP - Extensive cardiovascular characterization and follow-up of patients receiving immune checkpoint inhibitors: A prospective multicenter study
Presenter: Danielle Delombaerde
Session: Poster session 07
2185TiP - Belgian FORX trial: FOod interventions to Reduce immunotherapy toXicity
Presenter: Marthe Verhaert
Session: Poster session 07
2186P - KN046 in patients with thymic carcinoma: A prospective, single-arm, multi-centre, phase II study
Presenter: Wentao Fang
Session: Poster session 07
2187P - Efficacy and safety of gemcitabine as maintenance treatment in unresectable malignant pleural mesothelioma: A phase II randomized study
Presenter: Mohamed Emam Sobeih
Session: Poster session 07
2188P - First-line combination of toripalimab and chemotherapy in advanced thymic carcinoma: A prospective, single-arm, phase II trial
Presenter: hui'yang shi
Session: Poster session 07
2189P - Combining SBRT with GM-CSF and Peg-IFNα to induce abscopal effects in previously treated patients with stage IV thymic tumors
Presenter: Boyan Wang
Session: Poster session 07
2190P - First-line atezolizumab in combination with platinum etoposide in patients with metastatic lung large cell neuroendocrine carcinoma (LCNEC)
Presenter: Georgios Evangelou
Session: Poster session 07
2191P - Real-world outcomes of patients with malignant pleural mesothelioma (MPM) treated with combination nivolumab and ipilimumab in the first- or later line setting
Presenter: Sabine Schmid
Session: Poster session 07
2192P - Quality of life (QoL) of patients (pts) with advanced malignant pleural mesothelioma (aMPM) treated in a real-world setting
Presenter: Abhenil Mittal
Session: Poster session 07