Virtual Library

Start Your Search

Michiel Christoffel Botha



Author of

  • +

    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
    • +

      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): Michiel Christoffel Botha

      • 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

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.