Author of

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  P2.04 - Immunooncology (Not CME Accredited Session) (ID 953)

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

  • 26987

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    P2.04-11 - An IL-8/IFN-gammma/NLR Plasma Score to Predict Nivolumab Efficacy in Patients with NSCLC (ID 14139)

    16:45 - 18:00  |  Author(s): Luca Lalli
    • Abstract
    • Slides

    Background
    

    In the present study we investigated whether baseline plasma cytokines as well as neutrophil to lymphocyte ratio (NLR) could predict resistance to nivolumab in pre-treated patients with advanced non-small cell lung cancer (NSCLC).

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    From September 2015 to January 2018, 42 NSCLC patients receiving i.v. nivolumab 3 mg/kg every two weeks were included within a translational study. All the patients underwent CT-scan every 6 cycles and responses were evaluated by Response Evaluation Criteria in Solid Tumors (RECIST). Peripheral blood samples were obtained from the patients at baseline. A panel of cytokines and chemokines (IL-6, IL-8, CXCL10, CX3CL1, CCL2, VEGF, and IFN- gamma) were quantified in plasma by Cytokine Bead Array and their association with OS and TTP was assessed by Adaptive Index Modeling multivariable analysis. NLR in blood cell counts was also assessed for potential association with clinical outcomes.

    4c3880bb027f159e801041b1021e88e8 Result
    

    An Index Score was identified clustering patients into 4 groups with progressively worsening TTP and OS. The score was composed by higher IL-8 and NLR (above the cut-offs of 10.76 pg/ml and 5.4, respectively) and lower IFN-gamma level (below cut-off of 11 pg/ml). Patients with score 0-1 (i.e. with none or 1 altered parameter; n= 17) displayed a median TTP of 11 months (95% IC= 5-NA) and median OS of 16 months (95% IC= 12-NA); in contrast, patients with score 2-3 (2 or 3 altered parameters; n=23) showed a median TTP of 3 months (95% IC= 2-5) and median OS of 5 months (95% IC= 2-8). The divergences among both TTP and OS Kaplan Meyers curves were statistically significant (P<0.0001). NLR alone showed instead either a borderline association with OS (p=0.048) and no ability to predict TTP (p=0.23).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Baseline plasma levels of IL-8 and IFN-gamma potentiate the ability of NLR to predict resistance to nivolumab in pre-treated patients with advanced NSCLC. These data suggest that the systemic balance between neutrophil-related inflammation and lymphocyte anti-tumor immunity may condition response to immunotherapy in lung cancer.

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