Author of

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  P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

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    P2.01-88 - C-Reactive Protein (CRP) as a Predictive Marker for Survival in Patients with Advanced NSCLC Treated with First Line Pembrolizumab Monotherapy (ID 13612)

    16:45 - 18:00  |  Author(s): Tadasuke Shimokawaji
    • Abstract
    • Slides

    Background
    

    Pembrolizumab have shown longer activity in patients with advanced non-small cell lung cancer (NSCLC) especially when PD-L1 expression was high. But even with high PD-L1 expression, more than half of them failed to response. We focused on C-reactive protein (CRP), inflammatory protein measured routinely in clinical practice, to find out its role as predictive biomarker for pembrolizumab.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We analyzed advanced NSCLC patients with PD-L1 high expression (EGFR mutation (-), EML-4-ALK fusion (-)) who were treated with pembrolizumab as first-line therapy in our clinical practice. Patients received pembrolizumab (200mg/body, q3W) until progressive disease or unacceptable toxicity. During treatment period we measured serum biochemistry and blood cell count regularly.

    We evaluated the association the factors such as serum marker including inflammatory protein, age, performance status, histology, smoking status, prior radiation therapy and presence or absence ofimmune-related adverse events after treatment with the effect such as antitumor response, progression‑free survival (PFS) and overall survival (OS).

    4c3880bb027f159e801041b1021e88e8 Result
    

    A total of 31 patients treated with pembrolizumab from March 2017 to February 2018 were analyzed for this research. Their characteristics were: median age 72 (range 37-84),male/female 24/7, adenocarcinoma/squamous cell carcinoma/pleomorphic carcinoma/neuroendocrine carcinoma/NOS 17/5/3/1/5, clinical stage IIIB/IV/recurrence 3/21/7, median CRP level at pretreatment 1.15mg/dL (0.07-15.27). Among the candidate biomarker, there were no association except for CRP. Serum CRP level at pretreatment was not predictive, but change of serum CRP level at 6 weeks after anti-PD-1 therapy initiation was most predictive in the analysis. Depressed CRP group showed longer PFS and OS than elevated group (PFS: p=0.08, HR 0.29, OS: p=0.08, HR 0.28, log-rank test).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Our analysis suggests that serum CRP elevation at 6 weeks of treatment predict for longer survival when pembrolizumab was given as first-line treatment.This finding might be related to inflammation status of patients and efficacy of anti-PD-1 inhibitor.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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