Abstract 64P
Background
Immune checkpoint inhibitors (ICIs) demonstrated efficacy in NSCLC patients, but only minority of them archive a clinical benefit from the therapy. The aim of the study was to investigate predictive value of the new score based on pretreatment markers in NSCLC patients treated with ICIs.
Methods
The study included 181 patients with EGFR/ALK-negative metastatic NSCLC receiving anti-PD-1/PD-L1 monotherapy in second and subsequent lines. The clinical, morphological and laboratory parameters were obtained before the start of treatment in all patients included in the study. The endpoints were overall survival (OS) and progression-free survival (PFS).
Results
Overall median of OS and PFS was 13,7 and 4,9 months, respectively. Multivariate analysis for OS determined baseline neutrophil-to-lymphocyte ratio (NLR) >4.3 (HR 4.89, 95% CI: 3.16–7.62, p < 0.0001), non-smokers (HR 1.80, 95% CI: 1.21–2.68, p = 0.004) and ECOG ≥2 (HR 2.02, 95% CI: 1.06–3.91, p = 0.035) as negative prognostic factors. The multivariate analysis for PFS also indicated these markers as independent predictors of resistance to ICIs. The three parameters were included in the NSE score (NLR- 2 points, Smoking status- 1, ECOG- 1 point). According to the score patients were classified into 3 groups: good (0 point), intermediate (1–2 points) and poor prognosis (≥3 points). The median of OS for good, intermediate and poor outcomes were 33.7, 12.2 and 7.2 months, respectively (p < 0.0001). Also, the NSE score could predict PFS in NSCLC patients: the median was 17.1, 4.3 and 3.2 months for good, intermediate and poor prognostic groups (p < 0.0001).
Conclusions
The NSE score including pretreatment clinical and blood markers can help to predict survival in NSCLC patients receiving ICIs in second and subsequent lines.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.