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Konstantinos Kalbakis



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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      166P - Correlation of various clinical, imaging and laboratory parameters with outcome in patients with metastatic non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs): Results from a prospective, observational, single institution study (ID 491)

      12:30 - 13:00  |  Author(s): Konstantinos Kalbakis

      • Abstract
      • Slides

      Background

      PDL1 expression in the tumor is used as a biomarker predictive of benefit from ICIs in NSCLC. We prospectively evaluated clinical, imaging and laboratory parameters to identify additional factors that could be used for patient (pt) selection.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      Pt and disease characteristics, sites (brain, liver, bones) and extent (1 vs ≥ 2) of metastases, concomitant use of steroids, antibiotics, or chronic use of proton pump inhibitors, neutrophil to lymphocyte ratio and LDH were prospectively collected from pts with NSCLC treated with ICIs in the 2nd or 3rd line. Response rate ( RR ), Progression free survival ( PFS ) and overall survival ( OS ) data were prospectively recorded.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Forty-four pts, median age 69 years, 50% squamous, 50% non-squamous, were included in the analysis. Performance status was 0-1 in 75% and 2 in 25% of pts, 92.7% were active/former smokers and PDL1 was ≥1% in 62% of pts with available PDL1 status. Partial response was recorded in 20% of pts, 30% had stable and 50% progressive disease. Median PFS and OS were 2.7 and 7.6 months, respectively. Prolonged (≥14d, either within 30d pre- or during treatment) use of antibiotics (p = 0,007) and concurrent steroids (p = 0,047) were inversely correlated with response. In multivariate analysis, liver metastases [HR = 4 (CI: 1,6 – 9,9; p = 0.003)], prolonged antibiotic use [HR = 2,76 (CI: 1,8 – 6,4; p = 0,02)] and concurrent steroids [HR = 3,3 (CI: 1,4 – 8,1; p = 0,009)] were independent predictors of shorter PFS, whereas, only antibiotics had a negative impact on OS [HR 4,6 ( CI: 1,7-12, p = 0,003 )].

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      To our knowledge this is the first prospective evaluation of routine clinical parameters potentially associated with outcome from ICIs in NSCLC. Our data are in accordance with previous retrospective reports regarding the adverse effect of antibiotics and steroids in the outcome of pts. Moreover, we show that in these pts liver metastases are predictive for inferior outcomes.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      University Hospital of Heraklion, Crete, Greece.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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