Abstract 420P
Background
The prognostic role of inflammatory markers in lung cancer is well-established. Yet, their potential predictive value for clinical complications remains largely unexplored. The goal of this study is to establish if baseline values and dynamic changes in serum inflammatory markers are predictors of lung cancer complications.
Methods
A prospective single center cohort study was conducted from April 2015 to January 2023, including 241 patients (57% male) with newly diagnosed lung cancer, encompassing both small cell (16%) and non–small cell lung cancer (84%). Patient- and tumor-specific characteristics were recorded. Measurements of inflammatory markers and scores were obtained at baseline, at 3-month intervals until disease progression and at the time of any complication. Clinical complications were assessed using emergency room visits, hospitalizations and intensive care unit admissions as a proxy.
Results
Univariate cox analysis for time-to-first complication, accounting for death and disease progression as competing risks, revealed several significant baseline predictors: male sex, presence of inflammation-related symptoms, higher disease stage, elevated Charlson Comorbidity Index (CCI), Glasgow prognostic score (GPS), Prognostic Nutritional Index (PNI), Neutrophil-to-Lymphocyte Ratio (NLR) and Systemic Inflammation Response Index (SIRI) were associated with a higher risk of complications. A subsequent univariate Cox analysis with time dependent variables, based on the repeated collection of each variable, for time-to-first complication led to similar results (Table).
Table 420P| HR (95% CI) | ||
| Presence of symptoms† | 1.675 (1.199, 2.342)* | |
| Albumin | 0.533 (0.387, 0.734)* | |
| Neutrophil count | 1.028 (0.993, 1.065) | |
| Lymphocyte count | 0.860 (0.670,1.102) | |
| Lactate dehydrogenase (LDH) | 0.999 (0.996, 1.002) | |
| Platelet count | 1.009 (0.994, 1.024) | |
| GPS† | 0. | − |
| 1. | 0.926 (0.303, 2.824) | |
| 2. | 5.640 (2.410,13.158)* | |
| Gustave Roussy Immune Score (GRIm)† | 0. | − |
| 1. | 1.073 (0.729, 1.580) | |
| 2. | 1.550 (0.939, 2.558) | |
| mGPS† | 3. | 2.024 (1.081, 3.788)* |
| 0 | ||
| 1. | 1.447 (0.990, 2.114) | |
| 2. | 2.332 (1.453, 3.745)* | |
| NLR | 1.036 (1.019, 1.053)* | |
| Platelet to lymphocyte ratio (PLR) | 1.012 (1.005, 1.019)* | |
| PNI | 0.992 (0.978, 1.006) | |
| SIRI | 1.048 (1.020, 1.076)* | |
| SII | 1.071 (1.038, 1.104)* |
†categorical variable
*p < 0.05.
Conclusions
Our findings show that multiple inflammatory scores are significant dynamic predictive factors of clinical complications. These routinely measured variables could be used to develop a clinical score to stratify the risk of adverse events for all lung cancer patients undergoing systemic treatment.
Legal entity responsible for the study
Institut Jules Bordet - Hôpital Universitaire de Bruxelles (H.U.B), Brussels, Belgium.
Funding
European Lung Cancer Working Party (ELCWP).
Disclosure
T. Berghmans: Financial Interests, Institutional, Advisory Board: Bayer, Janssen, MSD, BMS, Daiichi Sankyo, Roche; Financial Interests, Institutional, Expert Testimony: Inhatarget; Financial Interests, Institutional, Invited Speaker: Pfizer, MSD, AstraZeneca, Novartis, Amgen, Novocure; Other, Personal, Other, Travel Grant: Takeda. M. Branda?o: Financial Interests, Institutional, Advisory Board, 03/2023: Sanofi; Financial Interests, Institutional, Invited Speaker, 01/2023: Takeda; Financial Interests, Institutional, Invited Speaker, 05/2023: Pfizer; Financial Interests, Institutional, Invited Speaker, June 2023: BMS; Financial Interests, Institutional, Invited Speaker, September 2023: BMS; Financial Interests, Institutional, Invited Speaker, October 2023: AstraZeneca, BMS; Financial Interests, Institutional, Invited Speaker, December 2023: Janssen; Financial Interests, Institutional, Advisory Board, Oct 2023: Amgen; Financial Interests, Institutional, Advisory Board, Dec 2023: Daiichi Sankyo; Financial Interests, Institutional, Invited Speaker, 01/2024 - Coimbra Thoracic IO meeting: MSD; Financial Interests, Institutional, Advisory Board, Feb and March 2024: AstraZeneca; Financial Interests, Institutional, Invited Speaker, 05/2024: MSD; Financial Interests, Institutional, Advisory Board, 05/2024: Janssen; Financial Interests, Institutional, Advisory Board, 06 and 09/2024: Inhatarget; Financial Interests, Institutional, Advisory Board, 07/2024: Pfizer; Financial Interests, Institutional, Advisory Board, 10/2024: AstraZeneca; Financial Interests, Institutional, Invited Speaker, ARTEMIDE-01 trial: AstraZeneca; Financial Interests, Institutional, Invited Speaker, IMforte trial: Roche; Financial Interests, Institutional, Invited Speaker, Beamion-Lung01 and Beamion-Lung02: Boehringer Ingelheim; Financial Interests, Institutional, Invited Speaker, CARMEN-LC: Sanofi; Financial Interests, Institutional, Invited Speaker, MCLA-129-CL01: Merus; Financial Interests, Institutional, Invited Speaker, DDriver: Merck; Financial Interests, Institutional, Invited Speaker, VERT-001: Pierre Fabre; Non-Financial Interests, Personal, Leadership Role, EORTC Lung Cancer Group - Young and Early Career group Chair (since January 2022): EORTC. All other authors have declared no conflicts of interest.