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Ibtihaj Fughhi



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    P1 - Poster Viewing (ID 5)

    • Event: NACLC 2019
    • Type: Poster Session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 10/11/2019, 16:45 - 18:00, Exhibit Hall
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      P1.05 - Clinical Factors Associated with Progression in Previously Treated Patients with Metastatic NSCLC on Anti-PD-1 Therapy (ID 106)

      16:45 - 18:00  |  Author(s): Ibtihaj Fughhi

      • Abstract

      Background:
      Known prognostic indicators for treatment outcomes in patients with metastatic NSCLC include tumor PD-L1 expression, tumor mutational burden (TBM), and neutrophil to lymphocyte ratio (NLR). This study reports patient characteristics associated with rapid progression (defined as progression within 30 days) in 141 patients with metastatic NSCLC who were treated with single-agent immune checkpoint inhibitors (ICI) at a tertiary care center.


      Method:
      A retrospective chart review and analysis of patients with previously treated stage IV NSCLC who received second or third line, single agent ICI was conducted. Pre-treatment (? 6 weeks prior to receiving ICI) values for weight, BMI, and NLR were compared to baseline values at initiation of treatment with ICI and correlated with rapid progression (progression at 1 month) and progression free survival (PFS).


      Results:
      141 patients were included in analysis. Of these, 59% were female, 70% were Caucasian, and 75% were current or former smokers. 85 patients had pre-treatment NLR values and 41% and 28% had NLR >3.5 and >5, respectively. 106 patients had pre-treatment weight and BMI available. Of these, 14% had pre-treatment BMI < 20, and 63% had a negative change in BMI prior to initiation of ICI with 26% of patients having had a >5% weight loss. Weight loss (p = <0.01) on a continuous scale and weight loss >5% (p = <0.01) were significantly associated with shorter PFS. Rapid progression (PFS *<* 30 days) was associated with pre-treatment NLR >3.5 (p = 0.02), increase in NLR from 6 weeks pre-treatment to baseline at initiation of therapy (p = <0.01), BMI decrease >5% (p = <0.01) and weight loss >5% (p = <0.01) prior to initiation of ICI. Rapid progression was additionally associated with pre-ICI changes in NLR, weight, and BMI analyzed as continuous variables (p = <0.01).


      Conclusion:
      This retrospective study identified clinical features of weight change and NLR in the pre-ICI treatment period that were associated with rapid progression on ICI therapy. These parameters should be investigated in the front line population and may have utility in identifying patients that would benefit from intensification of therapy beyond single agent ICI.