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Wungki Park
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EP1.01 - Advanced NSCLC (ID 150)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.01-61 - iSEND Model as a Predictor of Efficacy in Immune Checkpoint Inhibitors for Non-Small Cell Lung Cancer: Fukushima Cohort (Now Available) (ID 1689)
08:00 - 18:00 | Author(s): Wungki Park
- Abstract
Background
The expression of PD-L1 in tumor tissue and the number of gene mutations (TMB) in tumor tissue have been investigated as predictors of the efficacy of PD-1/PD-L1 inhibitors in non-small cell lung cancer. However. In actual clinical practice, it is difficult to perform these tests in all cases.
Therefore, we are searching for an effect prediction marker that can be done easily and inexpensively. Wungki Park et al. constructed the iSEND model as a therapeutic effect predictor and showed its usefulness. We examined the usefulness of iSEND model for non-small cell lung cancer patients who received PD-1 / PD-L1 inhibitor at our institution.
Method
We retrospectively examined the usefulness of the iSEND model in 56 patients with non-small cell lung cancer who were treated with PD-1/PD-L1 inhibitor in our department after the second treatment. The iSEND model uses patient background and blood tests. Calculated and scored using gender, ECOG performance status, NLR before treatment and after treatment (Neutrophi-to-Lymphocyte Ratios), and divided into three group. For each group, we statistically compared the clinical course such as overall survival and recurrence-free survival.
Result
In the analysis by Wungki Park et al. , The iSEND Poor group has a median overall survival of 4.0 months and 15.9 months, respectively, compared with the iSEND Good group (p = 0.0002), and the median recurrence free period is 1.6 months and 2.6 months, respectively. Months (p = 0.0045), and each showed a significant difference. In our study, no statistically significant difference was found, but a trend similar to the analysis of Wungki Park et al.
Conclusion
In this study, it is suggested that the iSEND model may be useful as a predictor of the effect of PD-1/PD-L1 inhibitor.
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MA07 - Clinical Questions and Potential Blood Markers for Immunotherapy (ID 125)
- Event: WCLC 2019
- Type: Mini Oral Session
- Track: Immuno-oncology
- Presentations: 1
- Now Available
- Moderators:David R Spigel, Roberto Ferrara
- Coordinates: 9/08/2019, 13:30 - 15:00, Vancouver (2003)
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MA07.02 - Early Change of dNLR Is Correlated with Outcomes in Advanced NSCLC Patients Treated with Immunotherapy (Now Available) (ID 2676)
13:30 - 15:00 | Author(s): Wungki Park
- Abstract
- Presentation
Background
The [neutrophils/[leucocytes-neutrophils] ratio (dNLR) correlates with immune checkpoint inhibitors (ICI) outcomes in advanced non-small cell lung cancer (aNSCLC) patients. Significance of early dNLR change after the first course of ICI is unknown.
Method
Patients with NSCLC treated with ICI (PD(L)1+/-CTLA4) between Nov. 2012 and Jun. 2018 at 16 EU/US centers were included. A control group treated with chemotherapy (CT) only was also evaluated (NCT02105168). dNLR was collected at baseline (B) and at cycle 2 (C2). Patients were categorized as low vs high dNLR at each timepoint (defined as < vs > 3, as previously done), and the change between B and C2 (good = low at both timepoints, poor = high at both timepoints, mixed = different at each timepoint).
Result
1485 patients treated with ICI were analyzed. PDL1 was negative in 162 (11%), 1-49% in 178 (12%), ≥50% in 201 (14%), and missing in 944 (64%). dNLR at B and C2 did not associate with PD-L1 status.
At baseline, dNLR was high in 509 (34%) patients and associated with worse PFS compared to those patients with low dNLR at baseline (HR 1.56, P<0.0001) and OS (HR 2.02, P<0.0001). At C2, dNLR was high in 484 (34%) and similarly associated with worse outcomes compared to patients with low dNLR at C2 (PFS HR 1.64, P<0.0001; OS HR 2.13, P<0.0001).
Between B and C2, dNLR remained low in 804 (56%, « good ») or high in 327 (23%, « poor ») or changed in 310 pts (22%, « intermediate »). Those with a good dNLR demonstrated mPFS 5.3, mOS 18.6 mo), followed by those intermediate with mixed dNLR (mPFS 3, mOS 9.2 mo), and finally poor dNLR (mPFS 2, mOS 5mo). Outcomes were independant of PD-L1 expression (adjusted HR for PFS 1.94 for intermediate and 3.16 for poor groups, compared to good dNLR group, P<.001; adjusted HR for OS was 2.08 for intermediate and 3.67 for poor groups, P<0.001).A bootstrap tested the stability of OS/PFS prediction (P<0.001).
In the chemo-cohort (n=173), high C1-dNLR (n=81, 47%) was not associated with OS (P=0.84).
Conclusion
dNLR at baseline, at cycle 2, and the change between these two timepoints associated with outcomes in patients treated with immunotherapy independent of PD-L1, but not in patients treated with chemotherapy alone. dNLR is specifically prognostic in the context of immunotherapy.
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