2177P - Immunotherapy adverse events association with inflammation scores: A real-world data analysis from a Portuguese hospital

Background

Immune checkpoint inhibitors (ICI) have revolutionized cancer treatment but they often carry a wide spectrum of immune-related adverse events (irAE), which might preclude treatment continuation. Biomarkers predictive of irAE would be useful to better select and manage patients for ICI therapy.

Methods

This retrospective analysis included patients treated with ≥3 cycles of ICI, regardless of the primary tumour, in a single hospital in Portugal, from January 2017 to December 2022. Data regarding irAE was collected, as well as baseline neutrophil-lymphocyte (NLR), platelet-lymphocyte (PLR) ratios and systemic imune-inflammation index (SII, given by platelets*neutrophils/lymphocytes). Scores were categorized using cutoff values described in literature, as NLR≥3, PLR≥180 and SII≥750. Descriptive analysis was performed using SPSS®. Association between the scores and irAE was analyzed using logistic regression.

Results

141 patients were included. 87% were males and the median age was 66. Most common diagnoses were non-small cell lung cancer (75%) and head and neck cancer (7%) and main ICI were pembrolizumab (53%), durvalumab (18%) and nivolumab (16%), with a 10 cycles median. 137 (97%) patients developed irAE: digestive (24%), cutaneous (20%), flu-like symptoms (12%) and others. 15% had grade ≥3 irAE, leading to ICI suspension in 11%. 55% died during follow-up, most due to disease progression, 1 due to irAE. Median inflammation scores were 3,5 (NLR), 175 (PLR) and 818 (SII). A statistically significant correlation was found between NLR≥3 and gastrointestinal (p 0,007, OR 0,375) and respiratory AE (p 0,023, OR 3,608); SII≥750 and gastrointestinal (p=0,015, OR=0,413), respiratory (p 0,020, OR 0,255) and musculoskeletal AE (p 0,015, OR 0,342); PLR≥180 and hepatic (p 0,045, OR 2,934) and musculoskeletal AE (p 0,045, OR 0,446). There was no correlation with the presence of grade ≥3 AEs nor with survival.

Conclusions

In this study baseline inflammation scores were associated with some irAEs but not with survival as described in literature. These findings support a correlation between systemic inflammation status and tolerability to immunotherapy and show the value of inflammatory scores as potential biomarkers of irAE.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

ULS Matosinhos - Hospital Pedro Hispano.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.