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Daniel A. Vorobiof



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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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      167P - Prognostic significance of neutrophil/lymphocyte ratio in patients undergoing treatment with nivolumab for recurrent non-small cell lung cancer (ID 513)

      12:30 - 13:00  |  Author(s): Daniel A. Vorobiof

      • Abstract
      • Slides

      Background

      Neutrophil-to-lymphocyte ratio (NLR) has prognostic value in several types of cancers. We investigated the influence of NLR in patients undergoing treatment with PD-1 checkpoint inhibitors for recurrent Non-Small Cell Lung Cancer (NSCLC).

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      Study CA 209-8C3, is a multicenter, non-interventional retrospective data analysis, which include patients who were previously treated for recurrent (unresectable or metastatic) NSCLC. Retrospective data was collected from 5 participating oncology centers.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      We analyzed data of 56 patients treated with nivolumab, 32 (57%) were male with a median age of 65 (46-86). Thirty-two (57%) had NSCLC specified as adenocarcinoma. Fifty (89%) patients had an ECOG performance status (PS) of 0 or 1, and 6 (11%) had an ECOG PS of 2. A ≥ 4 cut-off value for NLR was calculated using the receiving operating characteristic (ROC) curves. The median OS was 11 months. One and two-year survival was 45% (95% CI 32% - 58%) and 32% (95% CI 20% - 45%) respectively. Median progression-free survival (PFS) was 6 months (95% CI 4 – 8). Univariate analysis found the number of metastatic sites and a higher NLR to be associated with shorter OS. Patients with ≤2 metastatic sites had a median OS of 11.4 months and patients with >2 sites 6.10 months (HR = 3.29 [95% CI 1.23-8.78], p = 0.0174). Patients with NLR ≥4 at 5-weeks post treatment had a median OS of 8.13 months, with median OS not reached for patients with NLR <4 (HR = 4.18, p < 0.001). NLR ≥4 at 9-weeks post treatment were also significantly correlated with shorter OS (HR = 4.15, p = 0.001) with median OS of 7.28 months, median OS for NLR <4 not reached. In a Cox multiple regression model with age, gender, race, ECOG PS, diagnosis, smoking status and NLR at 3-, 5- and 9-weeks, NLR ≥4 at five-weeks post nivolumab was the only factor that retained significance (HR = 5.41 95% p < 0.001). Clinically relevant grade ≥3 toxicities include pneumonitis (n = 5), severe skin rash (n = 1), colitis (n = 1) and other (n = 3).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Elevated NLR is associated with a poor outcome in patients with recurrent metastatic NSCLC treated with nivolumab.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      BMS: Study CA 209-8C3.

      682889d0a1d3b50267a69346a750433d Disclosure

      B.L. Rapoport: Contract research, Advisory boards, Speaker: BMS, MSD, Roche South Africa, AstraZeneca; Research grant: BMS, Roche South Africa. All other authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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