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Lunch & Poster Display session

17P - Association of lung immune prognostic index (LIPI) with survival of first line immune checkpoint inhibitors single agent or in combination with chemotherapy in untreated advanced NSCLC patients

Date

12 Dec 2019

Session

Lunch & Poster Display session

Presenters

Felix Blanc-Durand

Citation

Annals of Oncology (2019) 30 (suppl_11): xi1-xi11. 10.1093/annonc/mdz447

Authors

F. Blanc-Durand1, E. Auclin2, D. Planchard1, S. Ponce Aix3, L. Hendriks4, I.G. Sullivan5, D. Saravia6, B. Routy7, R. Lopez Castro8, S. Pilotto9, F. Aboubakar10, E. Kassouf11, A. Rodriguez12, A. Amores Martin13, M.V. Bluthgen14, B. Duchemann15, C. Caramella16, E. Nadal17, B. Besse18, L. Mezquita18

Author affiliations

  • 1 Medical Oncology, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 2 Gastrointestinal And Medical Oncology Department, Hopital European George Pompidou, 75015 - Paris/FR
  • 3 Medical Oncology, University Hospital 12 De Octubre, 28041 - Madrid/ES
  • 4 Pulmonary Diseases, Maastricht University Medical Center (MUMC), 6202 AZ - Maastricht/NL
  • 5 Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, 08041 - Barcelona/ES
  • 6 Hematology/oncology Department, Jackson Memorial Hospital, 33136 - Miami/US
  • 7 Hemato-oncology, University of Montreal Research Center, H2X 3H8 - Montreal/CA
  • 8 Medical Oncology, University Clinical Hospital of Valladolid, 47011 - Valladolid/ES
  • 9 Medical Oncology, AOU Integrata Borgo Roma Verona, 37134 - Verona/IT
  • 10 Department Of Oncologie Thoracique, UCLouvain Brussels Woluwe, 1200 - Brussels/BE
  • 11 Medical Oncology, Centre Hospitalier Régional de Lanaudière, J6E 6J2 - St-Charles-Borromée/CA
  • 12 Medical Oncology, Institut Clínic de Malalties Hematològiques i Oncològiques, 08036 - Barcelona/ES
  • 13 Medical Oncology, Hospital Clinico Universitario de Salamanca, 37007 - Salamanca/ES
  • 14 Medical Oncology, Hospital Aleman, C1118AAT - Buenos Aires/AR
  • 15 Medical Oncology, Hôpital Avicenne, 93009 - Bobigny/FR
  • 16 Radiology, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 17 Medical Oncology, Institut Catala d'Oncologia (ICO), 08907 - Barcelona/ES
  • 18 Medical Oncology, Institut Gustave Roussy, 94805 - Villejuif/FR
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Resources

Abstract 17P

Background

The Lung Immune Prognostic Index (LIPI), combining the derived neutrophils/[leucocytes minus neutrophils] ratio (dNLR) and lactate dehydrogenase (LDH), has been associated with survival for ICI-single agent in large cohorts of refractory advanced NSCLC. However the role of LIPI in untreated NSCLC patients has not been explored yet. We assessed the value of LIPI in the front-line setting of advanced NSCLC patients (pts) treated with ICI-single agent or in combination with chemotherapy and compared to a cohort of pts treated exclusively with chemotherapy (CT).

Methods

Retrospective multicenter study of pts treated in first-line ICI single agent if PD-L1 ≥50% (ICI-cohort), or in combination with chemotherapy (Combo-cohort) from 15 centers worldwide. A control cohort with pts treated with platinum-based CT (CT-cohort) was extracted from the prospective MSN study. LIPI was calculated as previously reported. We correlated pretreatment LIPI with overall survival (OS) in the 3 cohorts.

Results

A total of 470 pts were enrolled in the three cohorts between 2011 and 2019. Median follow-up is 13.9 months. In the ICI-cohort (N = 252), 165 (65%) were male, with median age of 67, 195 (77%) with PS ≤ 1. Based on LIPI (available for 195 pts): 81 (42%) were considered good, 86 (44%) intermediate and 28 (14%) poor group. In the combo-cohort (N = 98), 71 (72%) were male, with median age of 66, and 84 (86%) with PS ≤ 1. Based on LIPI (available for 69): 23 (33%) were good group, 34 (49%) intermediate and 12 (17%) poor group. In the CT-cohort (N = 120), no differences were observed by LIPI groups. The impact of LIPI groups in the 3 cohorts is summarized in the table.

Table: 17P OS and PFS in the 3 cohorts; OS according to the LIPI groups

OSICI-cohortCombo-CohortChemo-cohort
Median PFS8.5m. [6.6-11.8]9.6m. [6.7-11]5.7m. [5.1-6.6]
Median OS21.3 m. 12.8-NR]24.7m. [14.9-25.7]13.8m. [9.6-15.3]
LIPI good Median OSNR [17.36-NR]25.7m. [25.6-NR]14.4 m. [9.6-18.1]
LIPI intermediate Median OSNR [9.2-NR]16.9 m. [12.8-NR]13.8 m. [8.5-15.8]
LIPI poor Median OS7.9m. [2.3-NR]6.2m. [5.7-NR]6.5 m. [6-NR]
P valueP = 0.01P = 0.02P = 0.19

NR: not reached; OS: overall survival; PFS: progression-free survival.

Conclusion

Pretreatment LIPI correlates with ICI survival in monotherapy and in combination with chemotherapy in front-line in advanced NSCLC pts. The correlation is not statistically significant in the chemotherapy alone group. The value of LIPI for ICI upfront should be explored in prospective clinical trials.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

E. Auclin: Travel / Accommodation / Expenses: Mundipharma; Speaker Bureau / Expert testimony: Sanofi Genzyme. D. Planchard: Honoraria (self), Honoraria (institution), Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: AstraZeneca; Honoraria (self), Honoraria (institution), Advisory / Consultancy: Bristol-Myers Squibb; Honoraria (self), Honoraria (institution), Advisory / Consultancy: Boehringer; Honoraria (self), Honoraria (institution), Advisory / Consultancy: Celgene; Advisory / Consultancy: Daiichi Sankyo; Honoraria (self), Honoraria (institution), Advisory / Consultancy: Eli Lilly; Honoraria (self), Honoraria (institution), Advisory / Consultancy: Merck; Honoraria (self), Honoraria (institution), Advisory / Consultancy, Travel / Accommodation / Expenses: Novartis; Honoraria (self), Honoraria (institution), Advisory / Consultancy, Travel / Accommodation / Expenses: Pfizer; Honoraria (self), Honoraria (institution), Advisory / Consultancy, Travel / Accommodation / Expenses: prIME Oncology; Honoraria (self), Honoraria (institution), Advisory / Consultancy: Peer CME; Honoraria (self), Honoraria (institution), Advisory / Consultancy, Travel / Accommodation / Expenses: Roche. L. Hendriks: Research grant / Funding (self), Travel / Accommodation / Expenses: Roche; Advisory / Consultancy, Research grant / Funding (self): Boehringer; Speaker Bureau / Expert testimony, Research grant / Funding (institution): AstraZeneca; Advisory / Consultancy, Travel / Accommodation / Expenses: Bristol-Myers Squibb; Advisory / Consultancy: Lilly; Honoraria (self): Quadia. B. Besse: Honoraria (institution): AbbVie; Honoraria (institution): Amgen; Honoraria (institution): AstraZeneca; Honoraria (institution): Biogen; Honoraria (institution): Blueprint Medicines; Honoraria (institution): Bristol-Myers Squibb; Honoraria (institution): Celgene; Honoraria (institution): Eli Lilly; Honoraria (institution): GSK; Honoraria (institution): Ingnyta; Honoraria (institution): Ipsen; Honoraria (institution): Merck KGaA; Honoraria (institution): MSD; Honoraria (institution): Nektar; Honoraria (institution): Onxeo; Honoraria (institution): Pfizer; Honoraria (institution): Pharma Mar; Honoraria (institution): Sanofi; Honoraria (institution): Spectrum Pharmaceuticals; Honoraria (institution): Takeda. L. Mezquita: Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Roche diagnostics; Speaker Bureau / Expert testimony: Bristol-Myers Squibb; Speaker Bureau / Expert testimony: Tecnofarma; Speaker Bureau / Expert testimony, Research grant / Funding (self): AstraZeneca; Travel / Accommodation / Expenses: Chugai. All other authors have declared no conflicts of interest.

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