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Jibran Ahmed



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    P3.04 - Immunooncology (Not CME Accredited Session) (ID 970)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.04-10 - Monocytes and Neutrophils as Predictive Markers of Response to Immune Checkpoint Inhibitors in Metastatic Non-Small Cell Lung Cancer  (ID 12286)

      12:00 - 13:30  |  Author(s): Jibran Ahmed

      • Abstract
      • Slides

      Background

      PD-L1 expression and mutational load in tumor cells have been found to predict response to immune checkpoint inhibitors (ICI) in patients with metastatic non-small cell lung cancer (mNSCLC). These parameters, however, are not readily available clinically. Identification of parameters easily measured in the clinics will help select NSCLC patients most likely to benefit from ICI.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A retrospective cohort study was carried out on patients with mNSCLC to identify clinical and laboratory factors associated with response to ICI.

      4c3880bb027f159e801041b1021e88e8 Result

      Of the 37 consecutive patients identified, only 32 patients were analyzed as 5 patients were not evaluable for response. There were 17 males and 15 females. Their median age was 64.5 years (range 20-84). History of smoking was present in 25/32 (78%) patients. Non-squamous cell tumors were by far the commonest histologic subtype (27/32, 84%). 12 patients received pembrolizumab, 19 patients nivolumab, and one patient received nivolumab followed by pembrolizumab. Responses were observed in 19 (59%) of these 32 patients. All 19 patients had partial response. There was no difference in the distribution of sex, age, smoking status, and histologic subtypes between responders and non-responders.

      The median time to response (TTR) in this cohort of patients was 12 weeks (range 6-24) and the median duration of response (DoR) was 24 weeks (range 7-112). Higher pre-therapy absolute monocyte counts (AMC) were correlated to shorter TTR (R = -0.50; 95% CI -0.79 – -0.05) (p = 0.03) but not DoR. Patients with AMC > 700/mm3 had a significantly shorter median TTR than those with AMC < 700/mm3 (8 weeks vs 12 weeks; p = 0.048). Lower absolute neutrophil counts (ANC) after dose #1 predicted response to ICI (p = 0.02). Patients with ANC < 4200/mm3 after dose #1 were more likely to respond than those with ANC >4200/mm3 (OR = 6.8; 95% CI 1.1 – 41.8) (p = 0.05). Pre- and post-therapy lymphocyte counts, platelet counts, or hemoglobin did not predict responses or DoR.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Higher pre-therapy AMC and lower post-dose #1 ANC in mNSCLC treated with ICI were correlated to improved probability of response. Analysis of AMC and ANC before and during therapy may provide an easy method to identify those mNSCLC patients most likely to respond to ICI.

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