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Coralia Bueno

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    P1.01 - Advanced NSCLC (Not CME Accredited Session) (ID 933)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.01-69 - Validation of the Lung Immune Prognostic Index (LIPI): Useful to Identify Resistance to PD-1 Checkpoint Inhibitors in Pretreated Lung Cancer (ID 14122)

      16:45 - 18:00  |  Author(s): Coralia Bueno

      • Abstract
      • Slides


      Derived neutrophils/(leukocytes-neutrophils) ratio (dNLR) and lactate dehydrogenase (LDH) level have been correlated with immune checkpoint inhibitors´ (ICI) outcomes. A lung immune prognostic index (LIPI) that showed association with ICI outcomes was developed by Mezquita L et al. based on these 2 systemic inflammation indicators (dNLR <3 and LDH > upper limit of normal (ULN)), characterizing 3 prognostic groups: good, 0 factors; intermediate, 1 factor; poor, 2 factors.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This is a multicenter retrospective study with the aim to validate prognostic value of LIPI score in pretreated advanced-stage non-small-cell lung cancer (NSCLC) treated with ICI. We included consecutive patients treated with nivolumab or pembrolizumab between March 2015 and April 2018 from 7 medical centers in Spain. Investigators at each institution retrospectively reviewed patients´medical records. Pretreatment LIPI score was calculated for all subjects and the primary endpoint was correlation with OS.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 168 patients were included. Median age 65 years (39-85). 134(79,8%) were male and 121 (72%) were PS≦1. Predominant histologies were adenocarcinoma (50%), and squamous-cell carcinoma (42,9%). 92,3% were treated with nivolumab and 7,7% with pembrolizumab. Median number of prior lines was 1 (1-5). Median number of cycles: 11 (1-68). Most were current or former smokers (94,6%). Only 2,3% had EGFR mutations, and 0,6% ALK rearrangement. PD-L1 immunohistochemistry was only available in 25% of patients (<1%: 36,6%; 1-49%: 39%; >=50%: 24,4%). After calculating LIPI score, 56,4% were LIPI 0 (good prognosis), 38,5% LIPI 1 (intermediate prognosis), and 5,1% LIPI 2 (poor prognosis). Response rate (RR) was 30,4% and disease control rate (DCR) 52%. The median PFS and OS were 5,6 months (m) (3,9-7,3) and 11,4 m (9,4-13,5). Median OS for good, intermediate, and poor was 14m (95% CI, 11,2-16,7), 6,3m (95% CI, 0,6-12) and 1,8m (95% CI, 0-4,3), respectively (p=0,0001). LIPI showed correlation with OS in patients with known PD-L1 status and also in those with no information about it. PFS was also correlated (p=0,004) with LIPI score. A LIPI score of 2 was independently associated with poorer OS (HR 4,9; 95% CI, 2,18-11,1).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Our results support the prognostic value of pretreatment LIPI score. dNLR >3 and LDH greater than ULN was correlated with worse outcomes for ICI, regardless of the knowledge of PD-L1 status. This is a useful tool, based on clinical criteria, that can help us in daily practice to identify which patients benefit from ICI.


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